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Coils migrate into the biliary-jejunum anastomosis: A case report
Jianwei Xu1, Hanxiang Zhan, Feng Li
1Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
Medicine
|February 9, 2019
Summary
Coil migration after arterial bleeding embolization is rare. Endoscopic removal of migrated coils causing biliary obstruction and jaundice proved effective, offering a new treatment option.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Hepatology
Background:
- Coil migration is a rare complication following endovascular embolization for arterial bleeding.
- Established treatment protocols for migrated coils in the biliary tract are lacking.
Observation:
- A patient developed intra-abdominal hemorrhage post-choledochal cyst excision, treated with micro-coil embolization.
- 122 days post-embolization, the patient presented with jaundice, fever, and chills, indicative of obstructive cholangitis.
- Endoscopy revealed micro-coils lodged in the biliary-jejunum anastomosis, causing biliary sludge adherence and obstruction.
Findings:
- Endoscopic intervention successfully cleared biliary sludge adherent to the migrated micro-coils.
- Post-procedure, total bilirubin levels significantly decreased, and the patient was discharged.
- Follow-up confirmed normalization of bilirubin levels, indicating successful management of obstructive cholangitis.
Implications:
- Endoscopic therapy presents a viable treatment option for rare cases of coil migration into the biliary tract.
- This approach can resolve secondary complications like cholangitis and jaundice caused by migrated embolic materials.
- Highlights the potential of minimally invasive endoscopic techniques for managing complex post-embolization complications.
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