Clin Endosc.  2021 Nov;54(6):920-923. 10.5946/ce.2020.228.

A Rare Case of Coil Migration into the Duodenum after Embolization of a Right Colic Artery Pseudoaneurysm

• Choi J
• Kim YM

• KMID: 2522715
• DOI: http://doi.org/10.5946/ce.2020.228

Abstract

Transcatheter arterial embolization is a safe and effective treatment for visceral artery aneurysms; nevertheless, some complications can occur. Coil migration to other organs after embolization is extremely rare, and only 16 cases have been reported previously. We report a rare case of coil migration to the duodenal lumen after embolization of a right colic artery pseudoaneurysm. To the best of our knowledge, this is the first case of coil migration after a right colic artery embolization. The patient exhibited no symptoms and was treated conservatively without any intervention. Some previous reports have demonstrated spontaneous coil passage and successful conservative management. Our case supports conservative treatment as the primary treatment for asymptomatic patients. Clinicians should assess the risks and benefits of coil removal in asymptomatic patients before performing any intervention.

Keyword

Adverse effects; Endoscopy; False aneurysm; Foreign-body migration; Therapeutic embolization

Figure

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  Fig. 1. (A) Computed tomography shows a pseudoaneurysm of the superior mesenteric artery (arrow) and hematoma in the small bowel. (B) Angiography shows a pseudoaneurysm of the branch of the right colic artery (arrow). (C) Embolization of the pseudoaneurysm was performed using coils. (D) Angiographic image after endovascular coiling shows multiple coils (arrow) in the successfully occluded pseudoaneurysm.

• 

  Fig. 2. (A, B) After 6 days of embolization, computed tomography reveals that the coils had migrated to the third wall of the duodenum (arrow). (C) Upper endoscopy shows that two strands of the wire penetrated the third wall of the duodenum (arrow). Surrounding granulation tissue is seen. (D) No interval change is observed at the 2-month follow-up computed tomography (arrow).

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