Abstract
Background and study aims Duodenal perforation by migration of plastic stents placed to treat biliary lesions
is rare but can be life-threatening. Surgical management is preferred, but it may
increase risks of mortality and morbidity, especially in patients with underlying
comorbidities and those of advanced age. We describe five cases of duodenal perforation
that were successfully managed endoscopically. Four patients were elderly, and one
had end-stage renal disease. We used cylindrically adapted cap-fitted endoscopy to
successfully retrieve migrated plastic stents and to close the perforated walls with
hemoclips. No post-procedural complication was noted. In conclusion, endoscopic management
is appropriate as a first-line approach in patients with duodenal perforations caused
by plastic stent migration.
