Post written by Corey O’Brien, MD, from the Department of Hospital Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

The case involved an elderly woman with locally advanced pancreatic adenocarcinoma. She was recently admitted for malignant gastric outlet obstruction and underwent successful placement of a gastrojejunal LAMS. She was readmitted shortly thereafter with occlusion of the distal flange of the LAMS by the contralateral wall of the jejunum. Two double-pigtail stents were placed through the LAMS to allow for patent drainage.

This is a novel method of resolving obstruction of a gastrojejunal LAMS caused by the contralateral wall of the jejunum.

Use of double pigtail stents is a viable option for relieving obstruction of a gastrojejunal LAMS stent, particularly in elderly patients with multiple comorbidities and prohibitive surgical risk factors.

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