Superior mesenteric artery (SMA) cover stent migration in a patient with SMA-duodenal fistula

Superior mesenteric artery (SMA)–duodenal fistula is a rare and potentially life-threatening condition. We report the case of a 61-year-old male who presented with sudden-onset abdominal pain, accompanied by nausea and vomiting. Computed tomography (CT) imaging revealed both acute calculous cholecystitis and a thrombosed SMA. A covered stent, previously inserted four years ago for a ruptured SMA aneurysm associated with a duodenal fistula, was found to have migrated into the ileocecal junction. The cholecystitis was treated with an open cholecystectomy. A follow-up abdominal X-ray at four weeks showed no evidence of the migrated stent, suggesting spontaneous evacuation. This case demonstrates a rare sequence of complications following endovascular stent insertion, including migration, thrombosis, and eventual loss of the stent. Clinicians should remain vigilant for these events in patients with a history of SMA stenting.