Clinical Journal of Gastroenterology

, Volume 12, Issue 2, pp 102–105 | Cite as

Size does matter: when a large plastic biliary stent ends up in the root of the mesentery

  • Konstantinos EkmektzoglouEmail author
  • Efstathios Nikou
  • Periklis Apostolopoulos
  • Despina Grigoraki
  • Konstantinos Manesis
  • Georgios Alexandrakis
Case Report


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.


Choledocholithiasis Plastic stent Duodenal perforation Ercp Mesentery 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human/animal rights

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

Informed consent was obtained from the patients included in the study.


  1. 1.
    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
  2. 2.
    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
  3. 3.
    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
  4. 4.
    ASGE Standards of Practice Committee, et al. Adverse events associated with ERCP. Gastrointest Endosc. 2017;85:32–47.CrossRefGoogle Scholar
  5. 5.
    Johanson JF, Schmalz MJ, Geenen JE. Incidence and risk factors for biliary and pancreatic stent migration. Gastrointest Endosc. 1992;38:341–6.CrossRefGoogle Scholar
  6. 6.
    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
  7. 7.
    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
  8. 8.
    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
  9. 9.
    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
  10. 10.
    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

Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of GastroenterologyArmy Share Fund Hospital (NIMTS)AthensGreece
  2. 2.Second Department of SurgeryArmy Share Fund Hospital (NIMTS)AthensGreece
  3. 3.Department of RadiologyArmy Share Fund Hospital (NIMTS)AthensGreece
  4. 4.AtticaGreece

Personalised recommendations