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Endoscopic stenting is useful for amelioration of gastrointestinal stenosis. This procedure benefits severely compromised patients who cannot afford surgery. Although the self-expandable metallic stent (SEMS) is safe, it is also associated with several complications such as perforation, migration, and fracture. Migration of a SEMS is not particularly rare; however, fracture of a SEMS is relatively rare. An 88-year-old man underwent stenting for dysphagia at another hospital. He was being treated for gastric cancer at the esophagogastric junction. After appropriate stenting, he regained his ability to eat and was discharged the hospital. Only 2 months later, however, he again lost his ability to eat and visited our hospital. Abdominal X-ray and computed tomography revealed a stent fracture. The proximal fragment was in the esophagus, and the distal fragment was in the stomach. An emergency operation involving gastrotomy and gastrostomy was performed. Open gastrotomy was performed to remove the fractured distal stent, and percutaneous tube gastrostomy was placed through the same gastric incision for nutrition support. The surgery was successful, and he was again able to eat. In this report, we discuss the occurrence of SEMS fracture within a short time periods after insertion. [ABSTRACT FROM AUTHOR]

An 86-year-old woman presented with a history of endoscopic papillary sphincterotomy for bile duct stones and diverticulitis. The patient was admitted as an emergency case of acute cholangitis due to choledocholithiasis, underwent endoscopic bile duct stenting, and was discharged with a plan for endoscopic lithotripsy. One month later, the patient was readmitted owing to abdominal pain. Abdominal computed tomography at admission showed that the bile duct stent had migrated to the sigmoid colon and the presence of a small amount of extraintestinal gas, suggesting a colonic perforation. Lower gastrointestinal endoscopy showed adhesions and intestinal stenosis in the sigmoid colon, probably after diverticulitis, and the bile duct stent that had perforated the same site. The stent was removed and endoscopic closure of the perforation was performed using an over-the-scope clip. Abdominal computed tomography 8 days after the closure showed no extraintestinal gas. The patient resumed eating and was discharged on the 14th day of admission. There was no recurrence of abdominal pain. Endoscopic closure of sigmoid colon perforation due to bile duct stent migration using an over-the-scope clip has not been reported thus far, and it may be a new treatment option in the future. [ABSTRACT FROM AUTHOR]