A 68‐year‐old man presented with melena in June 1993, and was diagnosed as having adenocarcinoma of the rectum with liver metastasis. He underwent anterior resection of the rectum and was given weekly chemotherapy. In October 1993, he developed jaundice due to severe stricture of the middle to lower common bile duct caused by metastatic spread to the lymph nodes around the pancreatic head. A 10mm wide, 51mm long WallstentTM (Schneider) was inserted into the lower end of the bile duct through the papilla, resulting in rapid normalization of the serum bilirubin level. Three months later, the Wallstent eroded through the duodenal wall, causing massive fatal hemorrhage. We, therefore, emphasize the necessity of being alert to the potential for such complications in cases involving placement of a self‐expanding metallic stent for malignant biliary stricture.
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