Trans-hepatic proximal migration of percutaneous-endoscopic biliary stent presenting as an abdominal wall abscess

Abstract

Endoscopically placed biliary prostheses or stents are an established method of relieving obstruction of the common bile duct, whether due to gallstones or stricture, with less morbidity than percutaneous placement 1 Speer AG Cotton PB Russell RCG. Randomised trial of endoscopic versus percutaneous stent insertion in malignant jaundice. Lancet. 1987; 2: 57-62 Abstract PubMed Scopus (590) Google Scholar or surgery. 2 Shepherd HA Royle G Ross AP. Endoscopic biliary endoprosthesis in the palliation of malignant biliary obstruction of the distal common bile duct: a randomised trial. Br J Surg. 1988; 75: 1166-1168 Crossref PubMed Scopus (499) Google Scholar In malignant disease, this procedure affords an improved quality of life by relieving obstructive jaundice, but is often technically difficult to perform because of tightness of the stricture or distortion of the anatomy. This may necessitate a percutaneous transhepatically inserted internal-external stent, with the possibility of converting it into an endoscopically inserted biliary stent. 3 Tan PC Lai ECS Hui WM Chan SCH. Pitfalls of percutaneous-endoscopic biliary stent placement. Am J Gastroenterol. 1990; 85: 207-209 PubMed Google Scholar Complications of both types of stent include stent blockage, sepsis, and migration that is usually distal. We report here a case of proximal migration of a percutaneous-endoscopic biliary stent presenting as an abdominal wall abscess.