PMC9307923_01
plain radiography X-ray showing both DJ stents at first insertion
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F1
The patient underwent a cystoscopy, bilateral DJ stent insertion, and urethrotomy due to urethral stricture and severe bilateral hydronephrosis by another urologist in another center (Figure 1).
plain radiography X-ray showing both DJ stents after failed removal
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F2
On plain radiography, the right DJ stent migrated upward (the distal coil of the DJ stent was at the level of the sacroiliac joint upon insertion), and the left DJ stent was totally forced and inserted into the abdominal cavity (Figure 2).
abdominal CT scan showing: A) distal coil of double J stent in the peritoneal cavity (arrow); B) double J stent in the peritoneal cavity (arrow); C) proximal coil of double J stent in the peritoneal cavity (arrow); D) helical computed tomography shows the DJ stent's total displacement in the peritoneal cavity (arrow)
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F3
An abdominal pelvic computed tomography (CT) scan was requested and showed the total migration of the left DJ stent to the abdominal cavity with suspected penetration of the bladder and jejunum by a proximal coil of the DJ stent and moderated free fluid in the abdominal cavity in favor of peritonitis (Figure 3).
intraoperative photos showing the double J stent in the peritoneal cavity (arrow)
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F4
During surgery, the DJ stent was identified to perforate the jejunum and caused trauma to the other bowel lope with severe adhesion between the bladder wall and the bowel content (Figure 4).
intraoperative images showing: A) the jejunal perforation site (arrow); B) the jejunal repaired; C) part of the jejunum resected
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F5
After removing the DJ stent, the injured part of the jejunum was resected, and the general surgery team performed an intestinal anastomosis (Figure 5).