Percutaneous retrieval of a biliary stent after migration and ileal perforation.
We present a case of a migrated biliary stent that resulted in a distal small bowel perforation, abscess formation and high grade partial small bowel obstruction in a medically stable patient without signs of sepsis or diffuse peritonitis. We performed a percutaneous drainage of the abscess followed by percutaneous retrieval of the stent. The entero-peritoneal fistula closed spontaneously with a drain in place. We conclude, migrated biliary stents associated with perforation distal to the Ligament of Trietz (LOT), may be treated by percutaneous drainage of the abscess and retrieval of the stent from the peritoneal cavity, even when associated with a large intra-abdominal abscess.
Culnan
Derek M
DM
Department of Surgery, The Pennsylvania State University, College of Medicine, M. S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
Cicuto
Bryan J
BJ
Department of Surgery, The Pennsylvania State University, College of Medicine, M. S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
Singh
Harjit
H
Department of Radiology, The Pennsylvania State University, College of Medicine, M. S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
Cherry
Robert A
RA
Department of Surgery, The Pennsylvania State University, College of Medicine, M. S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.