Duodenal perforation due to migrated biliary stent: Case report

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Medical Case Reports

Background:

• Biliary stents are commonly used for biliary obstruction.
• Complications associated with biliary stents are frequent.
• Duodenal perforation due to biliary stent migration is a rare but serious complication.

Purpose of the Study:

• To report a rare case of biliary stent migration leading to duodenal perforation.
• To highlight the diagnostic and management challenges of this rare complication.

Main Methods:

• Case presentation of a 33-year-old male with abdominal pain and fever.
• Diagnostic workup included X-ray abdomen and CECT abdomen.
• Surgical management involved exploratory laparotomy with repair and diversions.

Main Results:

• CECT abdomen confirmed biliary stent migration and duodenal perforation.
• Patient underwent successful surgical repair including Thal patch repair, pyloric exclusion, retrograde duodenostomy, and feeding jejunostomy.
• The post-operative period was uneventful.

Conclusions:

• Intestinal perforation, particularly duodenal perforation, is an uncommon but significant morbidity following common bile duct stenting.
• Clinical suspicion is essential in patients presenting with pain and fever post-biliary stenting.
• The fixed position of the duodenum may predispose it to perforation in cases of stent migration.