Emphysematous cholecystitis after endoscopic wallstent placement complicated by distal migration of the stent

Endoscopic placement of Wallstents was thought to be a less invasive procedure, and in previous publications serious complications were infrequent. We report here on the case of a 58-year-old man with unresectable pancreatic cancer who developed emphysematous cholecystitis after endoscopic placement of a Wallstent, which was further complicated by distal migration of the stent. A second stent had to be placed into the first to fully bridge the malignant stricture. Three days later, the patient developed cholecystitis and septic complications, and he finally died of septic shock with disseminated intravascular coagulation. This previously unreported complication should be considered if abdominal pain and high fever develop after Wallstent placement.