Migrated biliary stent complicated by small bowel obstruction

Less common complications reported are stent migration into the proximal or distal small bowel with a rate of 6 per cent.2 Stent migration has been reported to result in intestinal perforation, intra-abdominal abscess, fistula formation, and obstruction.3 Migration is more common when performed for benign strictures as opposed to malignant etiologies; this is likely secondary to continued inflammatory changes associated with the malignant process after stent placement, which aids in stabilizing the stent.4 Intestinal perforation was seen in 1 per cent of migrated stents, the most common perforations occurring proximal to the ligament of Treitz. [...]this additional insufflation may also have prevented the manual "milking" of the stent distally for endoscopic removal. Because this could not be performed, an enterotomy could not be avoided.