A Favorable Outcome for an Internally Maldeployed Double Pigtail Stent скачать в хорошем качестве

A Favorable Outcome for an Internally Maldeployed Double Pigtail Stent

A 31-year-old man with walled-off pancreatic necrosis and abdominal pain was referred for EUS-guided drainage of the collection. Given that the collection contained minimal solid necrotic material, two 7-French double pigtail stents were planned to be placed across the gastric wall. During placement, the second stent was inadvertently maldeployed, fully entering the cavity. A third stent was subsequently placed across the gastric wall to ensure adequate drainage. The decision was made to endoscopically remove the maldeployed stent after two weeks, once the cystogastrostomy tract had matured. However, the patient was lost to follow-up. Nine months later, he returned for a follow-up appointment, at which time an EUS was performed. The EUS revealed that the cavity had collapsed, and the two transgastric stents remained in appropriate positions. Unexpectedly, the internally maldeployed stent had migrated, penetrating the duodenal wall, with one end visible in the duodenal lumen. This migration occurred as the collapsing retroperitoneal cavity exerted pressure on the maldeployed stent, pushing it outward and through the duodenal wall. The maldeployed stent was removed using a snare, while the two transgastric stents were left in situ.