Presentation
Obstructive jaundice, with abdominal pain and vomiting.
Patient Data
A straight, plastic, biliary stent in situ. There is a noted absence of pneumobilia.
Incidental findings:
feacal loading and calcified fecaliths
T8 and T11 chronic wedge compression fractures (metastases not excluded)
lumbar degenerative changes
previous right femoral ORIF
left hip severe OA and remodeling, avascular necrosis is not excluded
iliac arterial calcified plaque
Case Discussion
Plastic biliary stents are often used for palliative purposes in patients with malignant biliary obstruction and poor prognosis.
Types:
straight
single pigtail
double pigtail
Straight stents usually have one, two or four flaps at each end to anchor them safely and prevent easy dislodgement.
The presence of pneumobilia may allude to a patent stent indirectly and hence the absence of pneumobilia may suggest an occluded stent, as in this instance.
This patient's background history was unknown at the time of the presentation.
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