An 84-year-old female was admitted to a hospital with a lumbar compression fracture; however, she had recurrent vomiting at the time of admission. Her serum hepatic transferase levels were elevated and bile duct dilation was observed by MRCP. She was transferred to our hospital with the diagnosis of obstructive jaundice. The attempted ERCP for biliary drainage failed because of duodenal stenosis, the endoscope did not pass through the stenosis. Her ECOG performance status score was 3, and surgery was not appropriate; thus, percutaneous transhepatic biliary drainage and endoscopic duodenal stenting were performed. Forceps biopsy of the duodenal mucosa was repeated from the mesh gap of the duodenal stent, but there were no signs suggesting malignancy. Upper gastrointestinal endoscopy was performed on post-stenting day 166, and forceps biopsy of the duodenal mucosa from the mesh gap of the duodenal stent led to the diagnosis of signet-ring cell carcinoma. Chemotherapy was not performed, and she died 193 days after the duodenal stenting.
