Intratumoral perforation following endoscopic duodenal stent placement for pancreatic cancer with gastric outlet obstruction.

Malignant gastric outlet obstruction is a common complication of advanced pancreatic cancer, leading to severe digestive symptoms and reduced quality of life. Endoscopic duodenal stent placement is a widely used palliative treatment; however, life-threatening complications, such as perforation, may occur. We present a case of a 74-year-old man with pancreatic cancer who developed intratumoral perforation following endoscopic duodenal stent placement for malignant gastric outlet obstruction. Imaging revealed tumor progression with necrosis and vascular involvement. This case highlights the need for careful risk assessment before duodenal stent placement, particularly in patients with tumor necrosis and ischemic risk.