Successful Closure of Chronic Colonic Double Perforation Caused by a Plastic Biliary Stent with Over-the-Scope Clip.

Introduction: Biliary stenting is commonly used for managing bile duct conditions, with stent migration occurring in up to 21% of cases. Colonic perforation from stent migration is rare, typically managed surgically or with conventional endoscopic clips. The use of over-the-scope clips (OTSCs) for such perforations is less documented.

Case presentation: An 89-year-old multimorbid woman presented with abdominal pain and new-onset constipation. Imaging revealed a migrated biliary stent causing sigmoid colon perforation. One year earlier, the stent had been placed for choledocholithiasis. Endoscopic removal of the stent and OTSC closure of the perforations were successfully performed, with no complications on follow-up.

Conclusion: This case demonstrates the successful use of OTSCs for closing a chronic colonic perforation caused by a migrated biliary stent. OTSCs may be a viable, less invasive alternative to surgery in similar cases.