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KMID : 1048120220110020089
International Journal of Gastrointestinal Intervention
2022 Volume.11 No. 2 p.89 ~ p.93
Distal migration of a partially covered duodenal stent requiring emergency surgical extraction
Campana Luca Giovanni

Fish Rebecca
Dickinson Owen Thomas
McNamara Mairead Geraldine
O¡¯Dwyer Sarah Theresa
Laasch Hans-Ulrich
Abstract
Duodenal stenting is an established alternative for the palliation of malignant gastric outlet obstruction (MGOO). Despite being relatively rare, stent migration remains an issue of concern. We present a case of duodenal stent displacement in a 71-year-old female with biliary and duodenal strictures secondary to pancreatic cancer. She presented with acute abdominal pain 10 days following the insertion of a 24-mm partially covered double-layer knitted device, which migrated to the ileocaecal junction. Since the priority was to minimise hospitalisation, we performed a laparotomy with extraction through an enterotomy combined with gastrojejunostomy to bypass the duodenum. The patient resumed oral intake on postoperative day 9 and tolerated a semi-solid diet for 3 months, until death. Despite continuous advances in enteral stent design, patient surveillance remains paramount. This report illustrates the complex decision-making around MGOO, addresses the management of stent migration, and highlights the role of surgery in simultaneously treating stent complications and palliating duodenal obstruction.
KEYWORD
Digestive system endoscopy, Duodenal obstruction, Pancreatic neoplasms, Stents, Surgical procedures, operative
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