Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent

<p>Abstract</p> <p>Introduction</p> <p>Retrievable plastic biliary stents are usually inserted endoscopically. When endoscopic placement fails, radiological percutaneous transhepatic placement is indicated. We report the occurrence of a case of delayed duodenal perforat...

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Main Authors: Hutchins Robert R, Thurley Peter, Ahmed Irfan, Fotiadis Nicos I, Papadopoulou Ioanna, Fotheringham Tim
Format: Article
Language:English
Published: BMC 2011-03-01
Series:Journal of Medical Case Reports
Online Access:http://www.jmedicalcasereports.com/content/5/1/103
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author Hutchins Robert R
Thurley Peter
Ahmed Irfan
Fotiadis Nicos I
Papadopoulou Ioanna
Fotheringham Tim
author_facet Hutchins Robert R
Thurley Peter
Ahmed Irfan
Fotiadis Nicos I
Papadopoulou Ioanna
Fotheringham Tim
author_sort Hutchins Robert R
collection DOAJ
description <p>Abstract</p> <p>Introduction</p> <p>Retrievable plastic biliary stents are usually inserted endoscopically. When endoscopic placement fails, radiological percutaneous transhepatic placement is indicated. We report the occurrence of a case of delayed duodenal perforation with abscess formation after radiological placement of a plastic stent. To the best of our knowledge, this is the first report of this complication after radiological stenting.</p> <p>Case presentation</p> <p>A 58-year-old Caucasian man had a mass 30 mm in size in the head of the pancreas and obstructive jaundice. He was referred for radiological insertion of plastic biliary stents after a failed endoscopic attempt. The procedure was uneventful, and the patient was discharged. Two weeks after the procedure, the patient presented with an acute abdomen and signs of sepsis. Computed tomography revealed erosion of the posterior duodenal wall from the plastic stent, and a large retroperitoneal abscess. The abscess was drained under computed tomography guidance, and the migrated stent was removed percutaneously with a snare under fluoroscopic guidance. Our patient had an uneventful recovery and was discharged after a week.</p> <p>Conclusion</p> <p>Late retroperitoneal duodenal perforation is a very rare but severe complication of biliary stenting with plastic stents. Gastroenterologists, surgeons and radiologists should all be aware of its existence, clinical presentation and management.</p>
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spelling doaj.art-8ffefe29631f484085e26586a17173782022-12-21T23:37:12ZengBMCJournal of Medical Case Reports1752-19472011-03-015110310.1186/1752-1947-5-103Perforation and abscess formation after radiological placement of a retrievable plastic biliary stentHutchins Robert RThurley PeterAhmed IrfanFotiadis Nicos IPapadopoulou IoannaFotheringham Tim<p>Abstract</p> <p>Introduction</p> <p>Retrievable plastic biliary stents are usually inserted endoscopically. When endoscopic placement fails, radiological percutaneous transhepatic placement is indicated. We report the occurrence of a case of delayed duodenal perforation with abscess formation after radiological placement of a plastic stent. To the best of our knowledge, this is the first report of this complication after radiological stenting.</p> <p>Case presentation</p> <p>A 58-year-old Caucasian man had a mass 30 mm in size in the head of the pancreas and obstructive jaundice. He was referred for radiological insertion of plastic biliary stents after a failed endoscopic attempt. The procedure was uneventful, and the patient was discharged. Two weeks after the procedure, the patient presented with an acute abdomen and signs of sepsis. Computed tomography revealed erosion of the posterior duodenal wall from the plastic stent, and a large retroperitoneal abscess. The abscess was drained under computed tomography guidance, and the migrated stent was removed percutaneously with a snare under fluoroscopic guidance. Our patient had an uneventful recovery and was discharged after a week.</p> <p>Conclusion</p> <p>Late retroperitoneal duodenal perforation is a very rare but severe complication of biliary stenting with plastic stents. Gastroenterologists, surgeons and radiologists should all be aware of its existence, clinical presentation and management.</p>http://www.jmedicalcasereports.com/content/5/1/103
spellingShingle Hutchins Robert R
Thurley Peter
Ahmed Irfan
Fotiadis Nicos I
Papadopoulou Ioanna
Fotheringham Tim
Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
Journal of Medical Case Reports
title Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
title_full Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
title_fullStr Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
title_full_unstemmed Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
title_short Perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
title_sort perforation and abscess formation after radiological placement of a retrievable plastic biliary stent
url http://www.jmedicalcasereports.com/content/5/1/103
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AT ahmedirfan perforationandabscessformationafterradiologicalplacementofaretrievableplasticbiliarystent
AT fotiadisnicosi perforationandabscessformationafterradiologicalplacementofaretrievableplasticbiliarystent
AT papadopoulouioanna perforationandabscessformationafterradiologicalplacementofaretrievableplasticbiliarystent
AT fotheringhamtim perforationandabscessformationafterradiologicalplacementofaretrievableplasticbiliarystent