Volume 4, Issue 4, Pages (April 2019)

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Volume 4, Issue 4, Pages 166-168 (April 2019) Rescue of a delayed spontaneously migrated lumen-apposing metal stent placed to facilitate transluminal ERCP in a patient with acute recurrent pancreatitis and pancreas divisum with Roux-en-Y gastric bypass  C. Roberto Simons-Linares, MD, MSc, John J. Vargo, MD, MPH, FACG, FASGE, Prabhleen Chahal, MD, FACG, FASGE  VideoGIE  Volume 4, Issue 4, Pages 166-168 (April 2019) DOI: 10.1016/j.vgie.2019.01.005 Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Fluoroscopic view confirming correct LAMS placement (blue arrow). VideoGIE 2019 4, 166-168DOI: (10.1016/j.vgie.2019.01.005) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Spontaneously migrated LAMS (blue arrow) completely lodged in the gastric remnant. VideoGIE 2019 4, 166-168DOI: (10.1016/j.vgie.2019.01.005) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Pancreatic stent in the dorsal duct (blue arrow), SEMS traversing the enterogastrostomy (green arrow) and migrated LAMS (red arrow); double pigtail through the SEMS to prevent dislodgment (yellow arrow). VideoGIE 2019 4, 166-168DOI: (10.1016/j.vgie.2019.01.005) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Fistula after LAMS (A) and SEMS (B) removal was cauterized with argon plasma coagulation. A 7F double-pigtail stent was left in situ through the fistula for future access. VideoGIE 2019 4, 166-168DOI: (10.1016/j.vgie.2019.01.005) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Follow-up small-bowel follow-through study confirming extravasation of contrast material into the gastric remnant (arrow). VideoGIE 2019 4, 166-168DOI: (10.1016/j.vgie.2019.01.005) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions