Document Detail


Fractured metallic biliary stent causing obstruction and jejunal perforation.
MedLine Citation:
PMID:  23879419     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Interventional internal drainage of the biliary tract has become an established procedure for both the temporary and definitive treatment of biliary obstruction due to malignant or benign disease. Biliary stent migration and stent fracture are known but rare complications. A 50-year-old man presented with acute onset pain in the abdomen and vomiting. He had undergone hepaticojejunostomy following a bile duct injury during open cholecystectomy 13 years before he presented at our institution. Subsequently, he developed a benign biliary stricture at the anastomotic site, which was stented transhepatically by a metallic stent. CT of his abdomen showed a fractured stent segment obstructing the jejunum with a localized perforation. Herein, we discuss his presentation and course of management, and review the factors influencing stent migration and fracture and the potential options for stent retrieval. The patient needed surgical intervention to retrieve the migrated fragment of metal stent and to resect the perforated jejunal segment. The role of endoscopic self-expanding metal stents for benign biliary disease remains controversial. A migrated stent that has become symptomatic should be removed endoscopically in early and accessible cases and surgically when endoscopic measures fail or when complicated by obstruction or perforation.
Authors:
Manickam Neethirajan Saravanan; Varughese Mathai; Dharmesh Kapoor; Balbir Singh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian journal of endoscopic surgery     Volume:  6     ISSN:  1758-5910     ISO Abbreviation:  Asian J Endosc Surg     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101506753     Medline TA:  Asian J Endosc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  234-6     Citation Subset:  IM    
Copyright Information:
© 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.
Affiliation:
Department of Surgical Gastroenterology, Global Hospital, Hyderabad, India.
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