Endobiliary Stent Migration Causing Ileal Perforation – A Case Report

Abstract

Common bile duct drainage (CBDD) following operative common bile duct exploration (CBDE) is routinely performed. Primary choledochotomy closure with trans-sphinteric endobiliary stent (EBS) is a popular technique. A 72-year-old woman presented with abdominal pain, peritonism, and sepsis a month after an elective right hemicolectomy with concurrent cholecystectomy and CBDE with EBS placement. Radiological investigations implied a detrimental consequence from migrated EBS. Surgical exploration revealed the cause to be ileal perforation by the EBS. She had a resection of the aggravated bowel segment and a double-barreled stoma was matured from the resected ends. The stoma was reversed 6 weeks after the laparotomy and the patient is currently under regular surveillance for colon cancer. Migration of EBS precipitating enteric perforation are uncommon, recognised complications. Natural, congenital, and acquired luminal and mural causes have been documented. Primary choledochotomy closure without CBDD, alternative EBS which are smaller or softer, and the utilization of T-Tube CBDD are valid options when treating patients with recognised increased risk of EBS-related bowel perforation.