# A Rare Case of Small Bowel Obstruction due to Migration of a Percutaneous Biliary Stent

## TL;DR

A rare case of small bowel obstruction caused by a percutaneously placed biliary stent is reported, highlighting an uncommon complication.

## Contribution

This is the first reported case of small bowel obstruction due to migration of a percutaneous biliary stent.

## Key findings

- A patient presented with ileal obstruction caused by a migrated and embedded covered stent.
- A lithiasic concretion at the stent tip was found to be the cause of the obstruction.
- The patient required laparoscopic diagnosis and ileal resection to resolve the issue.

## Abstract

Biliary endoprostheses are widely used in the treatment of biliary lithiasis, malignant and benign strictures, and occasionally in long-lasting biliary fistulas. They can be placed endoscopically during endoscopic retrograde cholangiopancreatography and radiologically (percutaneous) when the endoscopic route is not feasible. Complications associated with the endoscopic placement of biliary endoprostheses are well described in the literature, with migration being the most common. Intestinal obstruction is a rare complication associated with the migration of these devices. There are no reports in the literature of this complication occurring after percutaneous placement. We present a case of a patient who arrived at the emergency department with ileal obstruction secondary to the migration and concurrent embedding of a covered stent placed radiologically to treat a biliary leak after surgery. The patient underwent diagnostic laparoscopic and ileal resection, revealing a lithiasic concretion at the tip of the stent, causing the small bowel obstruction.