To report a case of delayed migration of metallic coils used in transcatheter arterial embolization into the biliary system, highlighting diagnostic challenges.
Approach:
Case Presentation: A 73-year-old man with recurrent choledocholithiasis and cholangitis following right hepatic artery embolization was evaluated through multiple ERCP procedures over two years.
Key Findings:
The patient developed recurrent biliary symptoms two years after embolization.
Imaging and ERCP failed to definitively localize the embolization material due to anatomical overlap.
A metallic wire-like structure was partially extracted during a later ERCP, confirming intrabiliary involvement.
Interpretation:
This case highlights the diagnostic challenges associated with the migration of embolization materials into the biliary system.
Limitations:
Definitive localization of the embolization material was not achieved until later ERCP procedures.
Imaging limitations due to anatomical overlap hindered early diagnosis.
Conclusion:
Repeated evaluations may be necessary when recurrent biliary symptoms occur after embolization.
