Duodenal perforations due to biliary stenting migration, although rare, can occur. We report a unique case of duodenal perforation due to a large in length plastic stent with no (or marginal) migration, which ended up in the root of the mesentery, explaining the normal laboratory values and minimal imaging findings observed. Any clinical symptom during the postprocedural period should raise the suspicion of a major complication and prompt quick management decisions.
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Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
Informed consent was obtained from the patients included in the study.
Soehendra N, Reynders-Frederix V. Palliative bile duct drainage—a new endoscopic method of introducing a transpapillary drain. Endoscopy. 1980;12:8–11.CrossRefGoogle Scholar
ASGE Standards of Practice Committee, et al. The role of ERCP in benign diseases of the biliary tract. Gastrointest Endosc. 2015;81:795–803.CrossRefGoogle Scholar
Dumonceau JM, Tringali A, Blero D, et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2012;44:277–98.CrossRefGoogle Scholar
ASGE Standards of Practice Committee, et al. Adverse events associated with ERCP. Gastrointest Endosc. 2017;85:32–47.CrossRefGoogle Scholar
Johanson JF, Schmalz MJ, Geenen JE. Incidence and risk factors for biliary and pancreatic stent migration. Gastrointest Endosc. 1992;38:341–6.CrossRefGoogle Scholar
Miller G, Yim D, Macari M, et al. Retroperitoneal perforation of the duodenum from biliary stent erosion. Curr Surg. 2005;62:512–5.CrossRefGoogle Scholar
Fatima J, Baron TH, Topazian MD, et al. Pancreaticobiliary and duodenal perforations after periampullary endoscopic procedures: diagnosis and management. Arch Surg. 2007;142:448–54.CrossRefGoogle Scholar
Arhan M, Odemiş B, Parlak E, et al. Migration of biliary plastic stents: experience of a tertiary center. Surg Endosc. 2009;23:769–75.CrossRefGoogle Scholar
Bagul A, Pollard C, Dennison AR. A review of problems following insertion of biliary stents illustrated by an unusual complication. Ann R Coll Surg Engl. 2010;92:W27–31.CrossRefGoogle Scholar
Namdar T, Raffel AM, Topp SA, et al. Complications and treatment of migrated biliary endoprostheses: a review of the literature. World J Gastroenterol. 2007;13:5397–9.CrossRefGoogle Scholar