• Tae Young Park, Sung Woo Hong, Hyoung-Chul Oh, and Jae Hyuk Do.
• Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
• Medicine (Baltimore). 2021 Dec 30; 100 (52): e28392e28392.

RationalePlastic endobiliary stents, after endoscopic retrograde cholangiopancreatography, can get spontaneously dislocated from the common bile duct and migrate intothe distal bowel. Most migrated biliary stents are removed with the passing of stool. However, migrated biliary stents can cause bowel perforation, albeit rarely, and surgical intervention may be required. Recently, we observed a colonic diverticular perforation caused by a migrated biliary stent, and we have reported this case with a review of the literature.Patients ConcernsA 74-year-old man presented with severe right lower quadrant pain after biliary stent insertion 1month ago.DiagnosesAbdominal computed tomography revealed perforation of the proximal ascending colon by the migrated biliary stent, combined with localized peritonitis.InterventionsEmergency diagnostic laparoscopic examination revealed penetration of the proximal ascending colon by the plastic biliary stent, and right hemicolectomy was performed.OutcomesOn pathological examination, colonic diverticular perforation by the biliary stent was confirmed. The patient was discharged without any additional complications.LessonsEndoscopic retrograde cholangiopancreatography endoscopists must always be cautious of the possibility of stent migration in patients with biliary stents in situ. In cases of biliary stent dislocation from the common bile duct in asymptomatic patients, follow-up with serial, plain abdominal radiographs, and physical examination is needed until confirmation of spontaneous passage through stool. In symptomatic cases suggesting peritonitis, abdominal computed tomography scan confirmation is needed, and early intervention should be considered.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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