Recurrent cholangitis due to an intrahepatic calculus caused by migrated coil for vascular embolization: A case report.

Abstract

Rationale: Pseudoaneurysm is a potential postoperative complication in hepatobiliary and pancreatic surgery, with catheter-based interventions being the first-line treatment. This study reviews the literature on potential secondary complications following arterial embolization. Additionally, we report a case in which a dislodged embolization coil acted as a nidus for bile duct stone formation, leading to recurrent cholangitis. This report aims to raise awareness among clinicians regarding such clinical scenarios.

Patient concerns: In the current report, we discuss the case of a 43-year-old male patient, who had undergone coil embolization due to a hepatic artery pseudoaneurysm after biliary reconstruction because of bile duct injury during the laparoscopic cholecystectomy, was admitted to our hospital for repeated cholangitis.

Diagnoses: Imaging modalities confirmed that the previously embolized coil had migrated into the bile duct, which was identified as the cause.

Interventions: A double-balloon endoscopy revealed stones with a migrated coil as its nucleus.

Outcomes: The endoscopic stone removal was completed.

Lessons: We encountered a case in which an arterial embolization coil used for the treatment of a pseudoaneurysm migrated into the bile duct, acting as a nidus for stone formation and resulting in recurrent cholangitis. In patients with a history of intrahepatic coil embolization, it is essential to first confirm the location of the coil within the vasculature and then investigate the underlying cause of stone formation. It is important to consider coil migration as a differential diagnosis in cases of bile duct stones following hepatic artery embolization with coils.