Jejunal Perforation Secondary to Migration of a Biliary Stent in a Liver Transplantation Patient: A Case Report

Abstract

Khaled Matar, Osaid Alser, Marwan Matar, Emad Al-Hout, Iyad Abo Jazr, Salah Al-Shami

Endoscopic retrograde cholangiopancreatography (ERCP) is the most frequently performed procedure for treating biliary strictures. Although small bowel perforation secondary to the biliary stent migration is rare, it can be life-threatening. Treatment strategies for such perforation continue to be debated. We report a case of 54-year male patient who was admitted to our hospital complaining of severe abdominal pain and fever. The patient has a history of a biliary stenting for anastomotic stricture following an orthotopic liver transplantation at another facility. Abdominal computerized tomography (CT) revealed migration of the biliary stent and perforation of the jejunum. Due to acute abdomen presentation, ERCP retrieval was not attempted, and exploratory laparotomy was carried out showing the stent perforating two adjacent jejunal loops resulting in adherence of two loops together. The patient had an uneventful recovery with no need for further endoscopic intervention for biliary re-stenting.

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