Case report of rare cause of small bowel obstruction: distal migration of metal biliary stent requiring enterotomy
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Date
2024-08
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Medip Academy
Abstract
Endoscopic biliary stent placement is a mainstay in the management of biliary strictures both malignant and benign. Distal stent migration is a known complication of metal biliary stents, however small bowel obstruction or perforation are rare. In this report from a tertiary referral centre, we detail a mid-small bowel obstruction caused by covered metal stent migration requiring a laparotomy and enterotomy for definitive management. A 69-year-old male was admitted to the Sunshine Coast University Hospital with obstructive jaundice on a background of previous metal biliary stent placement. On day 3 of his admission, he developed worsening abdominal pain. Cross-sectional imaging demonstrated distal migration of his stent to his mid-jejunum, causing a high-grade small bowel obstruction. He underwent laparotomy to retrieve the stent. He recovered well and underwent a percutaneous transhepatic cholangiogram with stent replacement. In this case, distal biliary stent migration causes a small bowel obstruction. Whilst uncommon, risk factors including previous intra-abdominal operation can be used to identify patients unlikely to achieve successful expectant management of distal migration.
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Keywords
Case report, Distal stent migration, Enterotomy, Laparotomy, Metal biliary stent, Small bowel obstruction
Citation
Rumble WT, Lonie JM, Donovan M, Kia C.. Case report of rare cause of small bowel obstruction: distal migration of metal biliary stent requiring enterotomy . International Surgery Journal. 2024 Aug; 11(8): 1343-1346