A Case of an Internal Pancreatic Stent Penetrating the Portal Vein after Pancreaticoduodenectomy for Ampullary Carcinoma

A 77-year-old man was diagnosed with ampullary carcinoma in follow-up upper gastrointestinal endoscopy after gastric cancer surgery. Pancreaticoduodenectomy was performed because distant metastasis was not found in a preoperative examination. An internal stent was placed at the site of pancreaticojejunal anastomosis during the operation. Grade B pancreatic fistula and intraabdominal abscess were found and interventional radiology was performed. Contrast-enhanced CT was performed because remittent fever was prolonged despite improvement of pancreatic fistula. CT showed that the end of the internal stent penetrated through the intestine into the portal vein, and portal vein gas and thrombosis were detected. We removed and replaced the stent in the intestinal lumen using a single-balloon enteroscope. The patient recovered after the endoscopic procedure and was discharged from hospital.