ENDOSCOPIC COIL EMBOLIZATION OF MAJOR INTRAHEPATIC BILIARY LEAK

A 45-year-old male who had recently undergone surgery for a giant hepatic hydatid cyst presented to the emergency with abdominal pain and fever. Cholangiography identified a major intrahepatic bile leak. A 80 x 10 mm fully-covered metal stent was inserted. Given the lack of improvement, the leaking bile branch was selectively cannulated and four 0.035’ Tornado coils were introduced through a retrieval balloon and deployed in the terminal end of the leaking duct. A subsequent cholangiogram revealed cessation of the leak. Six months later, CT revealed dilated CBD with a migrated coil inside. ERCP was performed and the coil extracted.