Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2012; 4(6): 266-268
Published online Jun 16, 2012. doi: 10.4253/wjge.v4.i6.266
Unusual penetration of plastic biliary stent in a large ampullary carcinoma: A case report
H Kerem Tolan, Tassanee Sriprayoon, Thawatchai Akaraviputh
H Kerem Tolan, Tassanee Sriprayoon, Thawatchai Akaraviputh, Department of Surgery, Division of General Surgery, Minimally Invasive Surgery Unit, Siriraj Gastrointestinal Endoscopy Center, Mahidol University, Bangkok 10700, Thailand
Author contributions: Tolan HK wrote the manuscript; Sriprayoon T read and provided critical comment on the manuscript; Akaraviputh T performed the procedure and revised the manuscript.
Supported by Faculty of Medicine Siriraj Hospital, Mahidol University
Correspondence to: Thawatchai Akaraviputh, MD, Siriraj Gastrointestinal Endoscopy Center, Minimally Invasive Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. sitak@mahidol.ac.th
Telephone: +662-419-8006 Fax: +662-412-1370
Received: October 16, 2011
Revised: April 13, 2012
Accepted: April 27, 2012
Published online: June 16, 2012
Abstract

Endoscopic biliary stenting is a well-established treatment of choice for many obstructive biliary disorders. Commonly used plastic endoprostheses have a higher risk of clogging and dislocation. Distal stent migration is an infrequent complication. Duodenum is the most common site of a migrated biliary stent. Intestinal perforation can occur during the initial insertion or endoscopic or percutaneous manipulation, or as a late consequence of stent placement. A 52-year-old male who presented with obstructive jaundice underwent endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. However, jaundice did not improve and he then underwent ERCP which revealed the plastic stent penetrating the ampullary tumor into the duodenal wall causing malfunction of the stent. A new plastic stent was inserted and the patient underwent Whipple’s operation. He is currently doing well after the operation.

Keywords: Complication; Endoscopic retrograde cholangiopancreatography; Penetration; Perforation