Self-Inflicted Wound: Spontaneous Pancreatic Duct Stent Migration Into Hepatic Parenchyma

Internal pancreaticojejunostomy (PJ) stents are used to reduce complications after pancreaticoduodenectomy but may rarely migrate. We report a case of PJ stent migration directly into the hepatic parenchyma. A 67-year-old woman with metastatic pancreatic adenocarcinoma developed recurrent cholangitis after pancreaticoduodenectomy. Initial obstruction was relieved with endoscopic gastrojejunostomy using a lumen-apposing metal stent. Six months later, imaging revealed PJ stent migration into the left hepatic lobe. Endoscopic removal was successful, but further biliary intervention was deferred due to thrombocytopenia and poor prognosis. This case highlights a novel cause of recurrent cholangitis and emphasizes individualized management in advanced malignancy.