Case Report of Colonic Perforation Due to a Migrated Biliary Stent

Abstract

Endoscopic biliary stent placement is a minimally invasive procedure performed in elderly and other high-risk patients. Therefore, the number of cases is increasing, but so is the number of complications associated with the procedure. The estimated stent migration rate occurring as a complication of this procedure is 5％-10％; however, gastrointestinal perforation is uncommon. Herein, we report our experience of a case of colonic perforation caused by biliary stent migration in a 91-year-old man. The patient had undergone stent placement (straight plastic stent, 7Fr, 9 cm) for the treatment of calculous cholangitis of the common bile duct 15 months prior to his first visit to us. The patient visited our hospital with primary an approximately 3-week history of lower abdominal discomfort. Abdominal computed tomography showed colonic perforation and abscess formation around the stent, and we performed laparotomy. No intraperitoneal contamination was noted during the procedure, and the stent was found to have penetrated the posterior wall of the sigmoid colon. The migrated stent was removed, and the abscess was drained. The procedure was completed by closing the perforation site by suturing. The patient was discharged 10 days after the surgery. In patients presenting with abdominal pain developing after biliary stent placement, it is essential to bear in mind the possibility of stent-associated intestinal perforation.