Unusual penetration of plastic biliary stent in a large ampullary carcinoma: A case report

Endoscopic biliary stenting is a well-established treatment of choice for many obstructive biliary disorders. Commonly used plastic endoprostheses have a higher risk of clogging and dislocation. Distal stent migration is an infrequent complication. Duodenum is the most common site of a migrated biliary stent. Intestinal perforation can occur during the initial insertion or endoscopic or percutaneous manipulation, or as a late consequence of stent placement. A 52-year-old male who presented with obstructive jaundice underwent endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. However, jaundice did not improve and he then underwent ERCP which revealed the plastic stent penetrating the ampullary tumor into the duodenal wall causing malfunction of the stent. A new plastic stent was inserted and the patient underwent Whipple's operation. He is currently doing well after the operation.