Abstract

ERCP plays a key role in biliary and pancreatic diseases diagnosis and treatment since its advent in 1979  and become an accepted modality in both benign and malignant biliary obstruction. ERCP  is  difficult and invasive endoscopic procedure with steep learning curve and continues to have high rates of complications[1]. Multiple  complications have been mentioned in the literature like perforation, migration of stent, pancreatitis and cholangitis[2]. Migration of stent is most common complication with incidence of  5–10% in  patients with biliary stents [3]. Perforation of Duodenum due to stent migration  is a  dangerous complication  with a low incidence rate and high  mortality rate of 4.2%–29.6% [1]. Less than 1%  of patients have perforation of any part of  git tract from duodenum to sigmoid colon due to stent migration.  [4–6]. Early diagnosis and appropriate modalities of management are main concerns.  Best  treatment methods for duodenal perforation in this scenario have not been established. Nonsurgical treatment methods can have  serious and life threatening  complications so decision of treatment modality  should be made carefully