Trans-duodenal migration of pancreatic duct stent into liver

Abstract

Endoscopic retrograde Cholangio-pancreatography (ERCP) is the one of the modalities for treating symptomatic pancreatic duct obstruction with dilation. A plastic stent placement is the standard technique followed. Complications after a plastic stent placement commonly found in the biliary tract in the form of migration into the duodenum with or without perforation have been widely described. Although complications of pancreatic duct stents are relatively rare, duodenal perforation secondary to pancreatic plastic stent migration into liver has not been described. Duodenal perforation results in perforative peritonitis when the intestinal contents leak into peritoneal cavity. However, stent migration resulting in duodenal perforation is a slow process where the inflammation results in adherence of surrounding organs, thereby preventing leak of intestinal contents into free peritoneal cavity. We present a case of contained duodenal perforation due to migration of pancreatic stent into liver. It is important to note that the chronic inflammatory process around the migrated pancreatic duct stent led to the asymptomatic nature patient in present case.