Ghirardelli Luca, Beneduce Aldo Alberto, Gusmini Simone
IRCCS San Raffaele Scientific Institute Milan, Italy.
J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241238527. doi: 10.1177/23247096241238527.
Biliary endoprostheses are widely used in the treatment of biliary lithiasis, malignant and benign strictures, and occasionally in long-lasting biliary fistulas. They can be placed endoscopically during endoscopic retrograde cholangiopancreatography and radiologically (percutaneous) when the endoscopic route is not feasible. Complications associated with the endoscopic placement of biliary endoprostheses are well described in the literature, with migration being the most common. Intestinal obstruction is a rare complication associated with the migration of these devices. There are no reports in the literature of this complication occurring after percutaneous placement. We present a case of a patient who arrived at the emergency department with ileal obstruction secondary to the migration and concurrent embedding of a covered stent placed radiologically to treat a biliary leak after surgery. The patient underwent diagnostic laparoscopic and ileal resection, revealing a lithiasic concretion at the tip of the stent, causing the small bowel obstruction.
胆道内支架广泛应用于胆石症、良恶性胆管狭窄的治疗,偶尔也用于长期存在的胆瘘。在内镜逆行胰胆管造影术期间可通过内镜放置,当内镜途径不可行时也可通过放射学方法(经皮)放置。与内镜放置胆道内支架相关的并发症在文献中有详细描述,移位是最常见的。肠梗阻是这些装置移位相关的罕见并发症。文献中没有经皮放置后发生这种并发症的报道。我们报告一例患者,该患者因术后胆漏经放射学方法放置的覆膜支架移位并同时嵌入导致回肠梗阻而入住急诊科。患者接受了诊断性腹腔镜检查和回肠切除术,发现支架尖端有结石,导致小肠梗阻。