A rare complication of biliary stent insertion: biliary stent migration causing jejunal perforation

Biliary stent placement is a common therapeutic intervention for biliary obstruction during endoscopic retrograde cholangiopancreatography. While generally safe, migration of these stents can occur. Distal migration leading to small bowel perforation is an exceptionally rare and life-threatening complication. We present the case of a 67-year-old female with a history of complex biliary disease and recent stent placement who presented with acute lower abdominal pain and septic shock. Computed tomography revealed a jejunal perforation caused by a migrated biliary stent. The patient underwent emergency exploratory laparotomy and small bowel resection. This case highlights the importance of maintaining a high index of suspicion for stent-related complications in patients presenting with an acute abdomen following biliary instrumentation, even months after the initial procedure.