Endoscopic ultrasound-guided repositioning of a migrated metal hepatogastrostomy stent using foreign body forceps.

Endoscopic ultrasound (EUS)-guided hepaticogastrostomy with a fully covered metal stent is an option for malignant biliary obstruction after a failed endoscopic retrograde cholangiopancreatography (ERCP) [1–3]; however, migration of the stent can be a fatal complication [3, 4]. We report a case in which a migrated stent was successful reset using a foreign body forceps. A 73-year-old woman developed abdominal pain and fever on the third day after EUS-guided hepaticogastrostomy with a metal stent (WallFlex Biliary RX, fully covered stent system; Boston Scientific, Galway, Ireland). A computed tomography (CT) scan showed that stent migration had occurred (●" Fig.1a, ●" Fig.1b, ●" Fig.1c) and an abdominal fluid collection had developed in the omental bursa (●" Fig.1d). Fig.1 Computed tomography (CT) scan images showing: a, b, c the migrated stent; d an abdominal fluid collection within the omental bursa.