Silent duodenocolic fistula secondary to biliary stent migration

Abstract

Duodenocolic fistula is mostly caused by colonic malignancy. Other benign inflammatory causes include peptic ulcer, inflammatory bowel disease and cholecystitis. Iatrogenic causes are rare, and mostly related to operative injury to the duodenum or colon. In the era of endoscopic surgery, biliary stenting is increasingly used to treat benign and malignant biliary obstruction. We report a patient with duodenocolic fistula formation that was secondary to a migrating biliary stent. The patient was totally asymptomatic and the diagnosis was made incidentally by computed tomography of the abdomen. The fistula tract was finally resected after removal of the biliary stent.

A Unique Management Strategy for Migrated Biliary Stent Causing Duodenal Perforation

“…She underwent endoscopic retrieval of the stent, although the fistula was not closed, and she remained asymptomatic. In the final case reported by Ha et al, 5 a patient underwent stent placement for obstruction because of cholangiocarincoma. One week later, a CT incidentally revealed the stent had perforated through the duodenum, leading to a duodenocolic fistula.…”

“…2 Duodenocolic fistula is a previously described, but exceedingly rare complication of stent migration. [3][4][5]…”