Small bowel perforation from a migrated biliary stent: A case report and review of literature

Abstract

BACKGROUND Bowel perforation from biliary stent migration is a serious potential complication of biliary stents, but fortunately has an incidence of less than 1%. CASE SUMMARY We report a case of a 54-year-old Caucasian woman with a history of Human Immunodeficiency virus with acquired immunodeficiency syndrome, chronic obstructive pulmonary disease, alcoholic liver cirrhosis, portal vein thrombosis and extensive past surgical history who presented with acute abdominal pain and local peritonitis. On further evaluation she was diagnosed with small bowel perforation secondary to migrated biliary stents and underwent exploratory laparotomy with therapeutic intervention. CONCLUSION This case presentation reports on the unusual finding of two migrated biliary stents, with one causing perforation. In addition, we review the relevant literature on migrated stents.

Late small bowel perforation from a migrated double plastic biliary stent: A case report and a review of literature of 85 cases from 2000 to 2022

“…There are very few incidences of small bowel perforation, and most published cases of bowel perforation from migrating biliary stents involve either duodenal or large intestinal perforation. Most individuals with perforation will exhibit widespread peritonitis and septic symptoms at presentation 7 . The level of infection in our case was high, and there was a sign of peritonitis.…”

“…Applying a biliary stent can create issues, including stent occlusion from clogging, which may lead to cholecystitis or cholangitis, pancreatitis from duct manipulation, bleeding, stent fracture, and stent migration. As various institutes have varying levels of experience, varied equipment is accessible, and different etiologic grounds for the intervention, the overall rate of biliary stent problems differs among them 7 …”

“…Therefore, there was a greater possibility that the stent would be damaged and fail to pass. Most institutions have policies to guarantee that all patients with stents are called back for stent removal 7 …”

Rare Complication of Sigmoid Colon Perforation by Migrated Plastic Biliary Stent: Two Case Reports and Literature Review

“…In general, distal biliary stent migration could pass through bowel tract without complications [2]. However, rare complications have been noted wherein the stents could not pass safely and affect the bowel wall, such as perforation, intra-abdominal abscess, fistula formation (enterocutaneous, and colovesical), and pelvic abscess formation [3]. Distal migration with colon perforation is an extremely rare complication with poorly defined treatment [4].…”

The Pierced Colon: When Biliary Stents Go the Wrong Way

“… 7 The majority was managed with endoscopic removal and closure, with however high mortality (3 of 11 6 vs 4 of 13 cases 7 ). While migration to unusual sites, such as the pericardium, 8 – 10 bronchial system, 11 and perforation of small bowel, 12 , 13 is limited to few case reports, colonic perforation has been reported in 32 cases since 2000 (Table 1 ), with only 5 cases outside the rectosigmoid colon, in which most perforations occurred because of impaction in thin-walled diverticula.…”