From Stent to Septic shock: A Rare Case of Tumor Ingrowth Through an Uncovered Self-Expandable Metal Stent Causing Life-Threatening Cholangitis in Pancreatic Head Carcinoma.

Abstract

We report a rare case of rapid tumor ingrowth causing complete occlusion of an uncovered self-expandable metal stent (SEMS) within two months of placement in a 65-year-old female patient with pancreatic head adenocarcinoma. The patient developed septic shock secondary to ascending cholangitis, requiring intensive care unit admission. Endoscopic retrograde cholangiopancreatography revealed complete stent occlusion due to tumor ingrowth. Successful salvage was achieved through coaxial placement of a covered SEMS through the occluded stent, with resolution of sepsis and restoration of biliary drainage. This case highlights the aggressive nature of pancreatic adenocarcinoma and the importance of vigilant monitoring for early stent failure, particularly in patients awaiting chemotherapy, where treatment delays can significantly impact survival outcomes.