Lehner Manuel, Heinrich Henriette, Baumgartner Benjamin, Heye Tobias, Zimmerli Marius
Clarunis Universitäres Bauchzentrum Basel, Gastroenterology, Basel, Switzerland.
Universitätsspital Basel, Radiology, Basel, Switzerland.
Case Rep Gastroenterol. 2025 May 29;19(1):381-386. doi: 10.1159/000545561. eCollection 2025 Jan-Dec.
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.
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.
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.
胆管支架置入术常用于治疗胆管疾病，支架移位发生率高达21%。支架移位导致结肠穿孔较为罕见，通常采用手术治疗或使用传统内镜夹。关于使用全层内镜夹（OTSC）治疗此类穿孔的报道较少。
一名89岁患有多种疾病的女性因腹痛和新发便秘就诊。影像学检查显示一枚移位的胆管支架导致乙状结肠穿孔。一年前，该支架因胆总管结石而置入。成功进行了内镜下支架取出术及OTSC穿孔闭合术，随访无并发症。
本病例证明了OTSC成功用于闭合由移位胆管支架引起的慢性结肠穿孔。在类似病例中，OTSC可能是一种可行的、侵入性较小的手术替代方案。
