Duodenal stenting is an established alternative for the palliation of malignant gastric outlet obstruction (MGOO). Despite being relatively rare, stent migration remains an issue of concern. We present a case of duodenal stent displacement in a 71-year-old woman with biliary and duodenal strictures secondary to pancreatic cancer. She presented with acute abdominal pain 10 days following the insertion of a 24-mm partially covered double-layer knitted device, which migrated to the ileocaecal junction. Since the priority was to minimise hospitalisation, we performed a laparotomy with extraction through an enterotomy combined with gastrojejunostomy to bypass the duodenum. The patient resumed oral intake on postoperative day 9 and tolerated a semi-solid diet for 3 months, until death. Despite continuous advances in enteral stent design, patient surveillance remains paramount. This report illustrates the complex decision-making around MGOO, addresses the management of stent migration, and highlights the role of surgery in simultaneously treating stent complications and palliating duodenal obstruction.
|International Journal of Gastrointestinal Intervention
|Accepted/In press - 21 Oct 2021