A Case of Double Sigmoid Colon Perforation and Pelvic Abscess due to Migration of a Biliary Stent

Abstract

Colon perforation by a migrated biliary stent is a rare late complication of endoscopic biliary stenting. We describe a case of a 74-year-old woman with double sigmoid colon perforation and pelvic abscess due to migration of plastic biliary stent. One year ago, endoscopic biliary stenting was performed for cholangitis due to choledocholisiasis at another hospital. Since she presented acutely with abdominal pain and pyrexia for two days, abdominal x-ray and CT scan were performed and demonstrated a migrated stent in the sigmoid colon and a huge pelvic abscess. Emergency laparotomy found double sigmoid colon perforation by a migrated plastic stent and a huge abscess between the sigmoid colon and the dorsal uterus. Hartmannʼs procedure and peritoneal drainage were performed. Although the endoscopic biliary stenting is a relatively safe procedure, such late complications as stent migration and perforation should always be kept in mind carefully.