Acute appendicitis due to appendiceal obstruction from a migrated biliary stent

Area of Science:

• Gastroenterology and Hepatology
• Endoscopic Procedures
• Biliary Tract Interventions

Background:

• Endoscopic plastic biliary stenting is a standard treatment for benign biliary conditions.
• While generally safe, complications such as stent occlusion and migration can occur with long-term use.
• Stent migration is a rare but serious complication, potentially leading to bowel obstruction or perforation.

Observation:

• A case of acute appendicitis was observed, stemming from an unusual cause: appendiceal orifice obstruction.
• The obstruction was identified as being caused by a migrated biliary stent.
• The patient's history and radiological findings were crucial in suspecting this rare complication.

Findings:

• The study reports an extremely rare instance of acute appendicitis secondary to a migrated biliary stent.
• The migrated stent led to obstruction of the appendiceal orifice, mimicking typical appendicitis symptoms.
• Nonoperative management, including endoscopic stent removal, proved successful in treating this condition.

Implications:

• This case underscores the potential for unusual complications arising from long-term biliary stenting.
• Physicians should consider migrated biliary stents in the differential diagnosis of appendicitis, especially in patients with a history of biliary stenting.
• Endoscopic stent removal offers a viable, nonoperative treatment option for this rare complication.