Jafferbhoy Sadaf F, Scriven Peter, Bannister Jeremy, Shiwani Muhammad Hanif, Hurlstone Paul
Department of General Surgery, Barnsley District Hospital NHS Foundation Trust, Barnsley, UK.
BMJ Case Rep. 2011 May 3;2011:bcr0420114078. doi: 10.1136/bcr.04.2011.4078.
Endoscopically deployed biliary stents are a well established method for dealing with biliary diseases. Perforation of the gut secondary to migrated biliary stent is reported in less than 1% cases. The authors present the first case of a colonic perforation from migrated biliary stent which was managed endoscopically. An 82-year-old female had a biliary stent for a postcholecystectomy bile leak and presented 6 months later with left iliac fossa pain. Barium enema showed a stent perforating the sigmoid colon. In view of the patient's frailty and absence of peritonitis, an endoscopic retrieval of stent was attempted. Flexible sigmoidoscopy showed a stent partially embedded within the sigmoid diverticulum which was successfully removed and the defect was closed endoscopically using three titanium clips. She had an uncomplicated recovery following the procedure and was discharged home on the second day following the procedure.
内镜下放置胆道支架是治疗胆道疾病的一种成熟方法。因迁移性胆道支架继发肠道穿孔的病例报告少于1%。作者报告了首例通过内镜处理的因迁移性胆道支架导致的结肠穿孔病例。一名82岁女性因胆囊切除术后胆漏置入了胆道支架，6个月后出现左下腹疼痛。钡剂灌肠显示支架穿透乙状结肠。鉴于患者身体虚弱且无腹膜炎，尝试通过内镜取出支架。乙状结肠镜检查显示支架部分嵌入乙状结肠憩室，成功取出支架，并使用三个钛夹在内镜下封闭缺损。术后她恢复顺利，术后第二天出院回家。
