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Article Details
Clinical Image
Volume 3, Issue 11 (November Issue)

Misplaced Lumen Apposing Metallic Stent: An Open Surgery

Nora A Althumiri1* and Mada H Basyouni2

1Department of Surgical Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

2Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia

*Corresponding author: Nora A Althumiri, Department of Surgical Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, E-mail: N_althumkfh@hotmail.com

Received: November 28, 2021; Accepted: December 06, 2021; Published: December 19, 2021

Citation: Althumiri NA, Basyouni MH, et al. Misplaced Lumen Apposing Metallic Stent: An Open Surgery. Clin Image Case Rep J. 2021; 3(11): 198.

Abstract

A 35 year female with a history of gall stone-induced acute necrotizing pancreatitis was referred to us in the second week of illness, she was managed conservatively with antibiotics and supportive measures given sepsis for a week. CECT (contrast- enhanced computed tomography) abdomen showed walled-off pancreatic necrosis (WOPN) and the necrosis was abutting the antro-pyloric region of the stomach. Endoscopic lumen apposing metallic stent was placed following endoscopic ultrasonography. One week later patient's symptoms were not relieved and she had multi-organ failure requiring ventilator support and a repeat CECT scan showed a displaced LAMS (Figure 1), given her clinical condition, the patient was planned for endoscopic removal of the stent, which was a failure. A percutaneous catheter was placed to stabilize her clinical condition but her clinical condition did not improve. Giver her clinical condition patient was operated on. On midline laparotomy, multiple adhesions lesser sac was entered with great difficulty because of multiple adhesions and the stent was removed (Figure 2). Postoperatively the patient was discharged on postoperative day 20. On follow-up, the patient has no symptoms.