Abstract
A 68-year-old man with epigastric pain was admitted for acute pancreatitis and obstructive jaundice caused by Primary pancreatic malignant lymphoma. Computed tomography showed diffuse enlargement of the whole pancreas and dilation of the main pancreatic duct and bile duct. Endoscopic retrograde cholangiopancreatography was performed to decompress these dilated ducts. After two courses of chemotherapy, follow-up computed tomography incidentally revealed migration of the pancreatic duct stent, which had perforated the contralateral duodenal wall to enter the peritoneal cavity. In the present case, pancreatic duct stent deviation was attributed to tumor shrinkage resulting from chemotherapy. In addition, stent migration into the peritoneal cavity occurred due to repeated mechanical manipulation of the pancreatic duct stent, presumably leading to partial ulceration of the duodenal wall and delayed wound healing during chemotherapy. This case may provide valuable information on the migration of pancreatic duct stents as a rare, stent-related late complication during chemotherapy.
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References
Webb TH, Lillemore KD, Pitt HA, et al. Pancreatic lymphoma-is surgery mandatory for diagnosis or treatment? Ann Surg. 1989;209:25–30.
Alexander RE, Nakeeb A, Sandrasegaran K, et al. Primary pancreatic follicle center-derived lymphoma masquerading as carcinoma. Gastroenterol Hepatol (N Y). 2011;7:834–8.
Ohkura Y, Lee S, Kaji D, et al. Spontaneous perforation of primary gastric malignant lymphoma: a case report and review of the literature. World J Surg Oncol. 2015;13:35.
Ramesh J, Hebert-Magee S, Kim H, et al. Frequency of occurrence and characteristics of primary pancreatic lymphoma during endoscopic ultrasound guided fine needle aspiration: a retrospective study. Dig Liver Dis. 2014;46:470–3.
Saranga BR, Rao P, Ghosh K. Iatrogenic duodenal perforations caused by endoscopic biliary stenting and stent migration: an update. Endoscopy. 2006;38:1271–4.
Lans JI, Geenen JE, Johanson JF, et al. Endoscopic therapy in patients with pancreas divisum and acute pancreatitis: a prospective, randomized, controlled clinical trial. Gastrointest Endosc. 1992;38(4):430–4.
Ghimire S, Ravi SJ, Yousef M, et al. Case report proximal migration of pancreatic duct stent in pancreas divisum: challenges in retrieval and review of the literature. Case Rep Gastrointest Med. 2021;2021:5531658.
Stassen PMC, de Jong DM, Poley J-W, et al. Prevalence of and risk factors for stent migration-induced duodenal perforation. Endosc Int Open. 2021;9(3):E461–9. https://doi.org/10.1055/a-1337-2321 (Epub 2021 Feb 19).
Paikos D, Gatopoulou A, Moschos J, et al. A rare complication of ERCP: duodenal perforation due to biliary stent migration. J Gastrointestin Liver Dis. 2006;15(4):387–8.
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The author Masayuki Kitano received speaking fees from Olympus Corporation. The funding source had no role in the design, practice or analysis of this study. The other authors have no COI to disclose.
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Taki, S., Maekita, T., Shimizu, R. et al. Migration of a pancreatic duct stent into the peritoneal cavity during chemotherapy for pancreatic malignant lymphoma. Clin J Gastroenterol 14, 1358–1363 (2021). https://doi.org/10.1007/s12328-021-01477-5
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DOI: https://doi.org/10.1007/s12328-021-01477-5