Endoscopic management of migrated biliary stent causing sigmoid perforation

Area of Science:

• Gastroenterology
• Endoscopy
• Biliary Interventions

Background:

• Biliary stents are common for biliary diseases.
• Gut perforation from migrated stents is rare (<1%).
• This is the first reported case of colonic perforation from a migrated biliary stent.

Observation:

• An 82-year-old female presented with left iliac fossa pain 6 months after biliary stent placement for a postcholecystectomy bile leak.
• Barium enema revealed the migrated stent perforating the sigmoid colon.

Findings:

• Endoscopic retrieval of the migrated biliary stent was performed due to patient frailty and absence of peritonitis.
• A flexible sigmoidoscopy confirmed the stent embedded in a sigmoid diverticulum.
• The stent was successfully removed, and the colonic defect was endoscopically closed with titanium clips.

Implications:

• Endoscopic management is a viable option for migrated biliary stent-induced colonic perforation, even in frail patients.
• This case highlights the potential for rare complications of biliary stents.
• Successful endoscopic intervention can avoid surgical morbidity.