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01.12.2011 | Case report | Ausgabe 1/2011 Open Access

Journal of Medical Case Reports 1/2011

Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2011
Autoren:
Ioanna Papadopoulou, Nicos I Fotiadis, Irfan Ahmed, Peter Thurley, Robert R Hutchins, Tim Fotheringham
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-5-103) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

IP has a major contribution in writing the manuscript. NF drafted and edited the manuscript. IA performed the percutaneous biliary drainage. PT performed a pecrcutaneous CT guided drainage and assisted with drafting the manuscript. RRH looked after the patient clinically and TF performed the percutaneous retrieval of the migrated stent. All authors read and approved the final manuscript.

Abstract

Introduction

Retrievable plastic biliary stents are usually inserted endoscopically. When endoscopic placement fails, radiological percutaneous transhepatic placement is indicated. We report the occurrence of a case of delayed duodenal perforation with abscess formation after radiological placement of a plastic stent. To the best of our knowledge, this is the first report of this complication after radiological stenting.

Case presentation

A 58-year-old Caucasian man had a mass 30 mm in size in the head of the pancreas and obstructive jaundice. He was referred for radiological insertion of plastic biliary stents after a failed endoscopic attempt. The procedure was uneventful, and the patient was discharged. Two weeks after the procedure, the patient presented with an acute abdomen and signs of sepsis. Computed tomography revealed erosion of the posterior duodenal wall from the plastic stent, and a large retroperitoneal abscess. The abscess was drained under computed tomography guidance, and the migrated stent was removed percutaneously with a snare under fluoroscopic guidance. Our patient had an uneventful recovery and was discharged after a week.

Conclusion

Late retroperitoneal duodenal perforation is a very rare but severe complication of biliary stenting with plastic stents. Gastroenterologists, surgeons and radiologists should all be aware of its existence, clinical presentation and management.

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