Retroperitoneal Perforation Caused by Migration of a Pancreatic Spontaneous Dislodgement Stent into Periampullary Diverticula

Masatake Nishiwaki; Chiemi Mizuno; Kota Yano; Hirohisa Oya; Ichiro Amano; Junko Matsumoto; Izumi Tanaka; Naoki Sawai; Masayuki Mizuno; Toshihide Shima; Yoshiharu Miyamoto; Takeshi Okanoue

doi:10.2169/internalmedicine.9054-17

CASE REPORTS

Retroperitoneal Perforation Caused by Migration of a Pancreatic Spontaneous Dislodgement Stent into Periampullary Diverticula

Masatake Nishiwaki, Chiemi Mizuno, Kota Yano, Hirohisa Oya, Ichiro Amano, Junko Matsumoto, Izumi Tanaka, Naoki Sawai, Masayuki Mizuno, Toshihide Shima, Yoshiharu Miyamoto, Takeshi Okanoue

Author information

Masatake Nishiwaki
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Chiemi Mizuno
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Kota Yano
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Hirohisa Oya
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Ichiro Amano
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Junko Matsumoto
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Izumi Tanaka
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Naoki Sawai
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Masayuki Mizuno
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Toshihide Shima
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan
Yoshiharu Miyamoto
Department of Surgery, Saiseikai Suita Hospital, Japan
Takeshi Okanoue
Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Japan

Keywords: pancreatic spontaneous dislodgement stent, periampullary diverticula, retroperitoneal perforation, pancreatic stent migration, ERCP complication

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 3 Pages 351-355

DOI https://doi.org/10.2169/internalmedicine.9054-17

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Details

Abstract

An 85-year-old woman underwent endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. Selective bile duct cannulation was unsuccessful because of periampullary diverticula (PAD). A pancreatic spontaneous dislodgement stent (PSDS) (5F diameter, 3 cm, straight type) was inserted to prevent post-ERCP pancreatitis. Three days after ERCP, she complained of abdominal pain, and computed tomography revealed retroperitoneal perforation because of PSDS migration to the PAD. If the papillary orifice is observed at the diverticular rim or in the diverticula, a pigtailed PSDS on the duodenal side or flanged stent on the pancreatic ductal side should be inserted in order to prevent this rare adverse event.

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