Endoscopic treatment for duodenal perforation due to biliary stent dislocation: A case report and brief review of the literature

Yuki Fujii, Kazuyuki Matsumoto, Kazuya Miyamoto, Akihiro Matsumi, Kosaku Morimoto, Hiroyuki Terasawa, Tatsuhiro Yamazaki, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato

Research output: Contribution to journalArticlepeer-review


Rationale: Duodenal wall perforation by a dislocated biliary stent placed for biliary structure is rare but can be life-threatening. There are few reports on the management of stent-related duodenal perforation. Patient concerns: Three cases included in this study had undergone endoscopic retrograde cholangiopancreatography with placement of a plastic stent for biliary stricture. Two cases had symptoms (fever or abdominal pain), while other case showed no symptom after biliary stent placement. Diagnoses: Dislocation of plastic stents was revealed on computed tomography or endoscopic images. Two patients were diagnosed with duodenal perforation due to distal migration of long stents with a straight shape on the distal side. One patient was diagnosed with fistula formation between the intrahepatic bile duct and duodenum due to perforation of a pigtail stent. Interventions: All cases could successfully be managed endoscopically with closure by hemoclips or stent replacement. Outcomes: All 3 cases were improved after endoscopic treatment without any subsequent intervention. Lessons: Longer stents with a straight distal side are associated with a higher risk of duodenal perforation. Endoscopic management is appropriate as a first-line approach for a clinically stable patient. At the time of stent placement, we should pay attention to the length and type of stent.

Original languageEnglish
Pages (from-to)E31868
JournalMedicine (United States)
Issue number48
Publication statusPublished - Dec 2 2022


  • biliary stent
  • endoscope
  • migration
  • perforation

ASJC Scopus subject areas

  • General Medicine


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