The Pierced Colon: When Biliary Stents Go the Wrong Way

Area of Science:

• Gastroenterology
• Endoscopy
• Biliary Interventions

Background:

• Bowel perforation is a rare but serious complication associated with biliary stenting.
• Straight plastic biliary stents are frequently used for biliary drainage.

Observation:

• A 78-year-old male presented with incidental finding of a biliary stent perforating the ascending colon on computed tomography.
• The patient was undergoing antibiotic therapy for a liver abscess at the time of detection.

Findings:

• Successful endoscopic stent extraction using a snare was performed.
• The perforation site was successfully closed using through-the-scope clips.
• The patient remained asymptomatic following the endoscopic intervention.

Implications:

• This case highlights the feasibility of endoscopic management for biliary stent-induced bowel perforation.
• Review of literature suggests straight plastic stents are commonly implicated in such perforations.
• Endoscopic closure offers a minimally invasive treatment option for this rare complication.