Malpositioned Right Ureteral Stent into the Duodenum: A Rare Case Report

Abstract

Double J (DJ) stenting is a routine procedure in our urological practice to treat ureteral obstruction. We report a rare case where
the proximal coil of a DJ stent was found in the second part of duodenum diagnosed on imaging and confirmed by upper gastro
intestinal endoscopy, in a patient with chronic right flank pain who underwent emergency right DJ stenting elsewhere. He pre
sented to our institution 3-months later for further management. It is important to be aware of all possible complications before
placing DJ stents and be aware that if any such complication arise, they need to be dealt with early. It is important to avoid blind
DJ stent insertion especially in acute or inflammatory conditions. One can avoid such situations by stenting under image guidance
and preferably with a retrograde pyelogram (RGP) or by deploying a guidewire under direct vision using a ureteroscope. If stent
malposition is suspected then early detection and replacement of the malpositioned DJ stent under fluoroscopic guidance is an
essential step in management.