First Case Report of Triple Recurrent Cholangitis of “Coildocholithiasis,” Following Hepatic Artery Pseudoaneurysm Embolization

Abstract

A 72-year-old man developed a hepatic artery pseudoaneurysm (HAP) caused by a liver abscess due to acute cholangitis and choledocholithiasis. He was successfully treated by transcatheter arterial embolization (TAE) with tornado microcoils. Two years later, he developed severe acute cholangitis caused by a biliary stone formed around a coil that had migrated into the common bile duct, termed “Coildocholithiasis.” The stone was removed successfully, while several coils remained in the liver. He subsequently experienced repeated “Coildocholithiasis” and cholangitis, and after the third episode of coil migration, no coil remained in the liver. Since HAP can be fatal if it ruptures, TAE has become a standard treatment for HAP and other arterial aneurysms. Coil migration to other organs is a rare late-onset complication. This is the first report of three consecutive coil migrations in one patient, discussing the mechanisms of migration and whether prophylactic endoscopic removal should be considered once asymptomatic coil migration into the bile duct is identified.