|Year : 2009 | Volume
| Issue : 3 | Page : 196
Silent percutaneous migration of plastic biliary stent through ileum
MA Joshi, BA Thakur, TG Dhopade, RS Kamble
Department of Surgery, Gastroenterology Surgical Services, L. T. M. Medical College, Sion, Mumbai - 400 022, India
|Date of Web Publication||2-Nov-2009|
M A Joshi
Department of Surgery, Gastroenterology Surgical Services, L. T. M. Medical College, Sion, Mumbai - 400 022
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Joshi M A, Thakur B A, Dhopade T G, Kamble R S. Silent percutaneous migration of plastic biliary stent through ileum. J Postgrad Med 2009;55:196
A 62-year-old male patient had undergone laparoscopic later converted to open cholecystectomy at another institute. He was referred to us for the treatment of postoperative jaundice by endotherapy. On admission he was subjected to Endoscopic Retrograde Cholangiography (ERC) which revealed a stricture in the common bile duct (CBD). This was dilated and initially a 7 F stent was placed. This normalized his liver functions and he was advised to follow up after three months for stent exchange with a large caliber one. When he presented for the same the 7 F stent had passed off and migrated from the biliary tract. The patient was unaware of passing the stent per anus in feces. This time the CBD was dilated with balloon and a tapered 10 F Teflon stent was placed. After about six months from the date of first ERC patient reported to us with passage of a black color tube [Figure 1] from his abdominal scar without any other symptoms. Patient was on full diet and did not have any abdominal symptoms whatsoever. A computed tomography (CT) scan of the abdomen revealed one end of the stent in the terminal ileum which was adherent to the abdominal wall at the site of the scar [Figure 2]. The 10F stent was in the biliary tract in proper position [Figure 3].
Such silent percutaneous migration of plastic biliary stent is very rare. This could be attributed to adherence of small bowel at the site of previous surgery. In our patient adherence of small bowel was seen on CT scan with the anterior abdominal wall with kinking of the ileum. This resulted in penetration of stent through the walls of the intestine and the abdominal wall without any peritoneal symptoms or peritonitis.
[Figure 1], [Figure 2], [Figure 3]