Endoscopic biliary stent placement is a minimally invasive procedure performed in elderly and other high-risk patients. Therefore, the number of cases is increasing, but so is the number of complications associated with the procedure. The estimated stent migration rate occurring as a complication of this procedure is 5％-10％; however, gastrointestinal perforation is uncommon. Herein, we report our experience of a case of colonic perforation caused by biliary stent migration in a 91-year-old man. The patient had undergone stent placement (straight plastic stent, 7Fr, 9 cm) for the treatment of calculous cholangitis of the common bile duct 15 months prior to his first visit to us. The patient visited our hospital with primary an approximately 3-week history of lower abdominal discomfort. Abdominal computed tomography showed colonic perforation and abscess formation around the stent, and we performed laparotomy. No intraperitoneal contamination was noted during the procedure, and the stent was found to have penetrated the posterior wall of the sigmoid colon. The migrated stent was removed, and the abscess was drained. The procedure was completed by closing the perforation site by suturing. The patient was discharged 10 days after the surgery. In patients presenting with abdominal pain developing after biliary stent placement, it is essential to bear in mind the possibility of stent-associated intestinal perforation.
"},{"@language":"ja","@value":"内視鏡的胆管ステント留置術は高齢者などの高リスク症例に対しても低侵襲な処置であるため施行例が増加している。それに伴い胆管ステント挿入に関連した合併症が増加している。ステントの逸脱率は5〜10％とされるが，消化管穿孔はまれである。逸脱した胆管ステントによる大腸穿孔の1例を経験した。症例は91歳，男性。1年3ヵ月前に総胆管結石性胆管炎に対して，総胆管内にプラスチックステント（ストレートタイプ，7Fr，9 cm）を留置された。3週間ほど続く下腹部の違和感を主訴に当院を受診した。CT検査でステントによる大腸穿孔および膿瘍形成と診断し，手術を行った。開腹すると腹腔内に汚染はなく，S状結腸後壁をステントが貫通していた。ステントを抜去し，膿瘍をドレナージした。穿孔部を縫合閉鎖し，手術を終了した。術後10日目に退院した。胆管ステント挿入後に腹痛を認めた場合はステントによる腸穿孔も念頭に置くことが必要である。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410579830877634561","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Shinbo Toshifumi"},{"@language":"ja","@value":"新保 敏史"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"南砺市民病院外科"},{"@language":"en","@value":"Department of Surgery, Nanto Municipal Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410579830877634560","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Urade Masaaki"},{"@language":"ja","@value":"浦出 雅昭"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"南砺市民病院外科"},{"@language":"en","@value":"Department of Surgery, Nanto Municipal Hospital"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13402242"},{"@type":"LISSN","@value":"13402242"},{"@type":"EISSN","@value":"18824781"},{"@type":"NDL_BIB_ID","@value":"000000091244"},{"@type":"ISSN","@value":"13402242"},{"@type":"NCID","@value":"AN10426469"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)"},{"@language":"ja","@value":"日本腹部救急医学会雑誌"},{"@language":"en","@value":"J Abdom Emerg Med"},{"@language":"en","@value":"Nihon Fukubu Kyukyu Igakkai Zasshi"},{"@language":"en","@value":"Journal of Abdominal Emergency Medicine"},{"@language":"ja","@value":"日腹部救急医会誌"}],"dc:publisher":[{"@language":"en","@value":"Japanese Society for Abdominal Emergency Medicine"},{"@language":"ja","@value":"日本腹部救急医学会"}],"prism:publicationDate":"2023-05-31","prism:volume":"43","prism:number":"4","prism:startingPage":"773","prism:endingPage":"776"},"url":[{"@id":"http://id.ndl.go.jp/bib/032909621"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I032909621"},{"@id":"https://search.jamas.or.jp/link/ui/2024086850"}],"availableAt":"2023-05-31","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E5%86%85%E8%A6%96%E9%8F%A1%E7%9A%84%E9%80%86%E8%A1%8C%E6%80%A7%E8%83%86%E9%81%93%E3%83%89%E3%83%AC%E3%83%8A%E3%83%BC%E3%82%B8","dc:title":"内視鏡的逆行性胆道ドレナージ"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%83%86%E7%AE%A1%E3%82%B9%E3%83%86%E3%83%B3%E3%83%88","dc:title":"胆管ステント"},{"@id":"https://cir.nii.ac.jp/all?q=%E9%80%B8%E8%84%B1","dc:title":"逸脱"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%A4%A7%E8%85%B8%E7%A9%BF%E5%AD%94","dc:title":"大腸穿孔"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2012223754"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I032909621"}]}