Acute appendicitis induced by biliary stent migration: A rare cause of acute abdominal pain. A case report

Background: Acute appendicitis is the most common cause of surgical acute abdomen worldwide. Its incidence is highest among individuals between 20 and 30 years of age, with no significant sex predilection. Clinical presentation can be variable, making early diagnosis challenging; therefore, imaging studies are essential to confirm the diagnosis. The vermiform appendix demonstrates considerable anatomical variability in both location and length, contributing to differences in clinical presentation. Despite established clinical criteria, diagnostic uncertainty persists in approximately 30–40% of cases, and surgical intervention based solely on clinical suspicion may result in normal appendices in 15–30% of procedures. Conversely, biliary stents are widely used in the management of various biliary and pancreatic conditions. Although stent migration is an uncommon complication, it is a recognized event. While distal migration typically remains asymptomatic, isolated cases of severe complications have been reported in the medical literature, including intestinal perforation, stent impaction, and gastrointestinal hemorrhage. Keywords: Appendix; Acute appendicitis; Appendectomy; Biliary stent; Choledocholithiasis; Endoscopic Retrograde Cholangiopancreatography.