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Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration

Received: 31 July 2023     Accepted: 21 August 2023     Published: 31 August 2023
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Abstract

Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of patients with biliary stent placement. Duodenal, ileal, jejunal and colon perforation due to biliary stent migration has been reported in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent implanted 7 months ago due to choledocholithiasis was admitted with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end perforating the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal cavity. The patient was successfully removed endoscopically due to the absence of abscess and peritonitis clinic. Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of biliary stent patients. Duodenal, ileal, jejunal and colonic perforation due to biliary stent migration tubules in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent inserted 7 months ago due to choledocholithiasis applied with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end in the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal wall. Due to the absence of abscess and peritonitis clinic on computed tomography, it was decided to plan an endoscopic procedure for the patient. In rectosigmoidoscopy, a plastic stent perforating the sigmoid colon wall and one end in the peritoneum was observed. The stent was removed with foreign body forceps. The perforation area formed by the stent was closed with a hemoclip. It should not be forgotten that stent migration and related perforation may occur in abdominal pain in patients with a history of biliary stent. Perforation cases without abscess and peritonitis clinic should be evaluated in terms of endoscopic treatments, as in our case.

Published in International Journal of Gastroenterology (Volume 7, Issue 2)
DOI 10.11648/j.ijg.20230702.13
Page(s) 54-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Biliary Stent, Colonic Perforation, Endoscopic Management

References
[1] Johanson JF, Schmalz MJ, Geenen JE. Incidence and risk for biliary and pancreatic stent migration. Gastrointest Endosc 1992; 38: 314-6.
[2] Odemiş B, Parlak E, et al. Migration of biliary plastic stents: experience of a tertiary center. Surg Endosc 2009; 23: 769-75.
[3] Wurbs D. The development of biliary drainage and stenting. Endoscopy 1998; 30: A202-6. 5.
[4] Chaurasia OP, Rauws EA, Fockens P, Huibregtse K. Endoscopic techniques for retrieval of proximally migrated biliary stents: the Amsterdam experience. Gastrointest Endosc 1999; 50: 780-5.
[5] Saranga Bharathi R, Rao P, Ghosh K. Iatrogenic duodenal perforations caused by endoscopic biliary stenting and stent migration: an update. Endoscopy 2006; 38: 1271–4.
[6] P. R. Mueller, J. T. Ferrucci, S. K. Teplick, et al. Biliary stent endoprosthesis: analysis of complications in 113 patients. Radiology 1985; 156: 637-639.
[7] N. A. Van der Gaag, E. A. Rauws, C. H. van Eijck, et al. Preoperative biliary drainage for cancer of the head of the pancreas NEJM 2010; 362: 129-137.
[8] D. J. Gouma Stent versus surgery HPB (Oxford). 2007; 9: 408-413.
[9] E. M. Anderson, J. Phillips-Hughes, R. Chapman. Sigmoid colonic perforation and pelvic abscess complicating biliary stent migration. Abdom Imaging. 2007; 32: 317-319.
[10] Storkson RH, Edwin B, Reiertsen O, et al. Gut perforation caused by biliary endoprosthesis. Endoscopy 2000; 32: 87-9.
[11] Miller G, Yim D, Macari M, et al. Retroperitoneal perforation of the duodenum from biliary stent erosion. Curr Surg 2005; 62: 512-5.
[12] Novacek G, Hormann M, Puig S, et al. Duodenal perforation secondary to placement of a biliary endoprosthesis diagnosed by multislice computed tomography. Endoscopy 2002; 34: 351.
[13] Katsinelos P, Paroutoglou G, Papaziogas B, et al. Treatment of a duodenal perforation secondary to endoscopic sphincterotomy with clips. World J Gastroenterol 2005; 11: 6232-4.
[14] Seibert DG. Use of an endoscopic clipping device to repair a duodenal perforation. Endoscopy 2003; 35: 189.
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  • APA Style

    Emin Bodakçi. (2023). Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration. International Journal of Gastroenterology, 7(2), 54-56. https://doi.org/10.11648/j.ijg.20230702.13

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    ACS Style

    Emin Bodakçi. Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration. Int. J. Gastroenterol. 2023, 7(2), 54-56. doi: 10.11648/j.ijg.20230702.13

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    AMA Style

    Emin Bodakçi. Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration. Int J Gastroenterol. 2023;7(2):54-56. doi: 10.11648/j.ijg.20230702.13

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  • @article{10.11648/j.ijg.20230702.13,
      author = {Emin Bodakçi},
      title = {Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration},
      journal = {International Journal of Gastroenterology},
      volume = {7},
      number = {2},
      pages = {54-56},
      doi = {10.11648/j.ijg.20230702.13},
      url = {https://doi.org/10.11648/j.ijg.20230702.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20230702.13},
      abstract = {Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of patients with biliary stent placement. Duodenal, ileal, jejunal and colon perforation due to biliary stent migration has been reported in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent implanted 7 months ago due to choledocholithiasis was admitted with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end perforating the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal cavity. The patient was successfully removed endoscopically due to the absence of abscess and peritonitis clinic. Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of biliary stent patients. Duodenal, ileal, jejunal and colonic perforation due to biliary stent migration tubules in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent inserted 7 months ago due to choledocholithiasis applied with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end in the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal wall. Due to the absence of abscess and peritonitis clinic on computed tomography, it was decided to plan an endoscopic procedure for the patient. In rectosigmoidoscopy, a plastic stent perforating the sigmoid colon wall and one end in the peritoneum was observed. The stent was removed with foreign body forceps. The perforation area formed by the stent was closed with a hemoclip. It should not be forgotten that stent migration and related perforation may occur in abdominal pain in patients with a history of biliary stent. Perforation cases without abscess and peritonitis clinic should be evaluated in terms of endoscopic treatments, as in our case.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration
    AU  - Emin Bodakçi
    Y1  - 2023/08/31
    PY  - 2023
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    DO  - 10.11648/j.ijg.20230702.13
    T2  - International Journal of Gastroenterology
    JF  - International Journal of Gastroenterology
    JO  - International Journal of Gastroenterology
    SP  - 54
    EP  - 56
    PB  - Science Publishing Group
    SN  - 2640-169X
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    AB  - Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of patients with biliary stent placement. Duodenal, ileal, jejunal and colon perforation due to biliary stent migration has been reported in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent implanted 7 months ago due to choledocholithiasis was admitted with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end perforating the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal cavity. The patient was successfully removed endoscopically due to the absence of abscess and peritonitis clinic. Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of biliary stent patients. Duodenal, ileal, jejunal and colonic perforation due to biliary stent migration tubules in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent inserted 7 months ago due to choledocholithiasis applied with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end in the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal wall. Due to the absence of abscess and peritonitis clinic on computed tomography, it was decided to plan an endoscopic procedure for the patient. In rectosigmoidoscopy, a plastic stent perforating the sigmoid colon wall and one end in the peritoneum was observed. The stent was removed with foreign body forceps. The perforation area formed by the stent was closed with a hemoclip. It should not be forgotten that stent migration and related perforation may occur in abdominal pain in patients with a history of biliary stent. Perforation cases without abscess and peritonitis clinic should be evaluated in terms of endoscopic treatments, as in our case.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Department of Gastroenterology, Ankara University, Ankara, Türkiye

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