Int J Gastrointest Interv.  2022 Apr;11(2):89-93. 10.18528/ijgii210044.

Distal migration of a partially covered duodenal stent requiring emergency surgical extraction

• Campana LG
• Fish R
• Dickinson OT
• McNamara MG
• O’Dwyer ST
• Laasch HU

• KMID: 2529425
• DOI: http://doi.org/10.18528/ijgii210044

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 doublelayer 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