Jejunal Perforation and Upward Migration of Double J Stents During the Cystoscopic Procedure: a Case Report and Review of Literature

Overview

Journal Pan Afr Med J

Date 2022 Aug 11

PMID 35949457

Authors

Faisal Ahmed

Qasem Alyhari

Saif Ghabisha

Saleh Al-Wageeh

Ebrahim Al-Shami

Menawar Dajenah

Waleed Aljbri

Fawaz Mohammed

Affiliations

Soon will be listed here.

Abstract

While double J (DJ) stenting is common worldwide in the urological procedure, it may associate with severe and catastrophic complications. Penetration of the jejunum and upward migration of double J (DJ) stents during cystoscopic DJ stent procedure are rare complications with few reported cases in the literature. We present a 65-year-old male presented with acute renal failure and peritonitis one week after failed cystoscopic removal of DJ stents. Radiographic investigations showed upward migration of the right DJ stent and a total displacement of the left DJ stent to the peritoneal cavity with peritonitis, bladder perforation, and jejunal injuries. The right DJ stent was removed via the ureteroscopic procedure. Then, open abdominal surgery was performed to remove the left DJ stent and repair the injured bladder wall and jejunal segment. In conclusion, synchronous upward DJ stent migration and peritoneal DJ stent malposition with jejunal and bladder injuries are rare and severe complications of the cystoscopic DJ stent procedure. The treatment should be performed depending on the time of diagnosis, nature of the injury, and general clinical conditions of the patient.

Citing Articles

Modified endoluminal ureteral stenting for the management of proximal ureteral obstruction in two cats.

Khoo T, Wang S, Chambers B, McMillan A, Yates G JFMS Open Rep. 2023; 9(2):20551169231210449.

PMID: 38115862 PMC: 10729628. DOI: 10.1177/20551169231210449.

References

J S, T M, Bafna S, Jain N . Laparoscopic Management of a Misplaced Ureteral Stent in the Duodenum. J Endourol Case Rep. 2021; 6(4):451-453. PMC: 7803274. DOI: 10.1089/cren.2020.0178. View

Rhee J, Steele S, Beiko D . Percutaneous antegrade nephroscopic holmium laser pyelotomy: Novel endourologic technique for removal of extruded ureteral stent. Can Urol Assoc J. 2014; 7(11-12):E830-2. PMC: 3879731. DOI: 10.5489/cuaj.1258. View

Dyer R, Chen M, Zagoria R, Regan J, Hood C, Kavanagh P . Complications of ureteral stent placement. Radiographics. 2002; 22(5):1005-22. DOI: 10.1148/radiographics.22.5.g02se081005. View

Slaton J, Kropp K . Proximal ureteral stent migration: an avoidable complication?. J Urol. 1996; 155(1):58-61. View

Burns E, Smith P, Liew M . Proximal migration of a 'double J' ureteric stent in a patient with a staghorn calculus. J Surg Case Rep. 2021; 2020(12):rjaa527. PMC: 7769553. DOI: 10.1093/jscr/rjaa527. View

Palthe S, Dijkstra G, Steffens M . A case of spontaneous urinary bladder rupture secondary to urinary retention due to an urethral stricture. Urol Case Rep. 2018; 17:85-87. PMC: 5849873. DOI: 10.1016/j.eucr.2018.01.009. View

Ruiz-Tovar J, Gonzalez R, Conde S, Morales V, Martinez-Molina E . Jejunal and bladder perforation: complication of intravesical Nd-YAG laser irradiation of bladder tumour. Acta Chir Belg. 2008; 108(5):595-6. DOI: 10.1080/00015458.2008.11680294. View

Ghaoui-Mansour H, Mortier P, Koskas Y, Gaillet S, Toledano H, Ragny-Ghazarossian E . An exceptional migration of ureteral stent after antegrade placement: A case report. Urol Case Rep. 2019; 26:100932. PMC: 6676010. DOI: 10.1016/j.eucr.2019.100932. View

Wall I, Baradarian R, Tangorra M, Badalov N, Iswara K, Li J . Spontaneous perforation of the duodenum by a migrated ureteral stent. Gastrointest Endosc. 2008; 68(6):1236-8. DOI: 10.1016/j.gie.2008.02.083. View

10.

Kholis K, Palinrungi M, Syahrir S, Syarif , Azis A, Ricardo S . Neglected double-J stent with giant bladder stone: a case report. Pan Afr Med J. 2021; 39:213. PMC: 8486933. DOI: 10.11604/pamj.2021.39.213.29865. View

11.

Katz R, Meretyk S, Gimmon Z . Abdominal compartment syndrome due to delayed identification of a ureteral perforation following abdomino-perineal resection for rectal carcinoma. Int J Urol. 1998; 4(6):615-7. DOI: 10.1111/j.1442-2042.1997.tb00320.x. View

12.

Haghpanah A, Ahmed F, Hosseini S, Mashayekh A, Dehghani A, Rastin S . Peritoneal perforation and peritonitis after antegrade double-J stent insertion: A case report and review of the literature. Clin Case Rep. 2022; 10(2):e05436. PMC: 8831974. DOI: 10.1002/ccr3.5436. View

13.

Ozgur Tan M, Yuceturk C, Uygur M, Erol D . Case report: further upward migration of a misplaced double-J ureteral stent. Int Urol Nephrol. 2003; 34(3):285-7. DOI: 10.1023/a:1024481315434. View

14.

Turri F, Manassero F, Mogorovich A, De Maria M, Falleni A, Selli C . Complete intraperitoneal displacement of a double J stent: a first case. Arch Ital Urol Androl. 2015; 87(1):95-7. DOI: 10.4081/aiua.2015.1.95. View

15.

Boopathy Vijayaraghavan K, Rajendran R, Thomas A . A rare presentation of renocolic fistula due to misplaced ureteral stent - presentation, management and literature review. Urol Case Rep. 2020; 33:101305. PMC: 7573846. DOI: 10.1016/j.eucr.2020.101305. View

16.

Kar A, Angwafo F, Jhunjhunwala J . Ureteroarterial and ureterosigmoid fistula associated with polyethylene indwelling ureteral stents. J Urol. 1984; 132(4):755-7. DOI: 10.1016/s0022-5347(17)49859-4. View

17.

Bagley D, Huffman J . Ureteroscopic retrieval of proximally located ureteral stents. Urology. 1991; 37(5):446-8. DOI: 10.1016/0090-4295(91)80108-j. View

18.

Ivica S, Dragan S . Long-term indwelling double-J stents: bulky kidney and urinary bladder calculosis, spontaneous intraperitoneal perforation of the kidney and peritonitis as a result of "forgotten" double-J stent. Vojnosanit Pregl. 2009; 66(3):242-4. DOI: 10.2298/vsp0903242s. View