Giant stentolith: A rare complication of long-dwelling biliary endoprosthesis |
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| Institution: | 1. Department of Pathology, Hôpital Saint-Antoine, AP–HP, Paris, France;2. Radiology Department, Hôpital Saint-Antoine, APHP, Paris, France;3. Pathology Department, American University, Beyrouth, Lebanon;1. Department of Medicine, Marienhausklinik St. Josef Kohlhof, Klinikweg 1-5, 66539 Neunkirchen, Germany;2. Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany;1. Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, Hirakata, Osaka, Japan;2. Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi University, Nangoku, Kochi, Japan;1. Section of Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway;2. Department of Clinical Medicine, University of Bergen, Bergen, Norway;3. Gastrointestinal Endoscopy Excellence Center and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand;4. Pancreas Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;5. Department of Surgery, Prapokklao Hospital, Chanthaburi, Thailand |
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| Abstract: | Endoscopic biliary stenting is performed for various indications in routine clinical practice. Plastic stents are indicated primarily for short-term biliary decompression and require removal or exchange after 12–16 weeks. However, patients who become asymptomatic after the procedure may not return for scheduled stent removal and subsequently present with severe complications. We herein present the case of a 57-year-old female who underwent biliary stenting after the endoscopic clearance of bile duct stones. Her symptoms resolved after the intervention, but she was lost to follow-up with the stent remaining in situ. Four years later, she presented with pain in the right hypochondrium and experienced recurrent episodes of cholangitis. Magnetic resonance cholangiopancreatography revealed a retained plastic stent in the proximal bile duct with a large stone cast around the stent—a stentolith. Owing to the large stone size and proximal migration of the retained biliary stent, the patient required open surgical exploration for stentolith removal. Patients with forgotten biliary stents presenting with serious complications are not uncommon in India. Unaware of the complications of long-dwelling biliary stents, patients ignore the advice for the timely removal of biliary stents. Detailed patient counselling, education and documentation are essential to avoid this condition. |
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| Keywords: | Cholangitis Cholelithiasis Choledocholithiasis Magnetic resonance cholangiopancreatogram Stent |
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