# From the Pancreas to the Groin: A Scrotal Abscess Following Pancreatic Fully Covered Self-Expandable Metal Stent Placement

## TL;DR

A rare case of a scrotal abscess occurred after a pancreatic stent was placed, showing unexpected infection spread.

## Contribution

Highlights a rare complication of FCSEMS use and emphasizes risks in benign pancreatic strictures.

## Key findings

- A scrotal abscess developed following FCSEMS placement for a benign pancreatic duct stricture.
- Infection spread from the pancreas through the paracolic gutter and inguinal canal.
- The case underscores the risks of FCSEMS in benign conditions and calls for cautious use.

## Abstract

Fully covered self-expandable metal stents (FCSEMSs) have gained popularity in the endoscopic management of pancreatic duct strictures, particularly in refractory cases. Although they may offer potential advantages over other stents, recent studies have raised concerns about increased rates of stent-related complications, including migration, secondary strictures, and bile duct obstruction. We report the case of a 49-year-old male with alcohol-induced chronic pancreatitis who developed a rare and extensive infectious complication, including a scrotal abscess, following FCSEMS placement for a benign pancreatic duct stricture. Imaging and culture data suggested a contiguous spread of infection from the peripancreatic region through the paracolic gutter and inguinal canal. This case illustrates a rare but serious complication of FCSEMS use and reinforces the need to avoid their routine use in benign strictures. It also highlights the importance of recognizing underappreciated risks such as side branch obstruction and extrapancreatic infectious spread.