Abstract
Duodenal perforation due to biliary stent migration is rare, and it often requires surgical repair; however, endoscopic closure has recently become a viable option in the appropriate patients. We present the case of a 79-year-old female who underwent biliary stent placement for a common bile duct stricture, who subsequently was found to have a duodenal wall perforation secondary to stent migration. The stent was extracted endoscopically with successful defect closure using a ConMed® repositional DuraClip™. We aim to contribute to the limited body of literature that describes endoscopic repair of duodenal perforation secondary to biliary stent migration using through-the-scope endoclips.
Highlights
The duodenum is perforated more readily than other portions of the intestine due to its comparatively thin wall
A number of etiologies may account for this occurrence, biliary stent migration has been reported as the cause in rare instances
We present the case of a 79-year-old female who developed a duodenal wall perforation secondary to biliary stent migration, which was extracted and closed using a ConMed® repositional DuraClipTM
Summary
The duodenum is perforated more readily than other portions of the intestine due to its comparatively thin wall. Advances in endoscopic surgery have led to an increased use of endoclips to close luminal defects, yet there are few reports of the utilization of through-the-scope (TTS) endoclips to close defects caused by migrated biliary stents. We present the case of a 79-year-old female who developed a duodenal wall perforation secondary to biliary stent migration, which was extracted and closed using a ConMed® repositional DuraClipTM. This is the first reported use of this TTS endoclip for a defect caused by biliary stent migration. A 79-year-old female with past medical history of chronic lymphocytic leukemia (in remission) presented to New YorkPresbyterian Queens with complaint of chest pain radiating to the back with associated nausea
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