A Curious Case of Coil-Angitis

A 43-year-old man with a history of pedestrian-truck collision 18 months prior presented with right-sided abdominal pain and chills. His trauma consisted of orthopedic injuries and a grade 4 liver laceration. Surgical liver repair was complicated by a biloma requiring common bile duct stenting. Postendoscopy hemobilia led to extensive coiling of a hepatic artery pseudoaneurysm. Remaining hospitalization was relatively uneventful, and he was lost to follow-up. Repeat presentation was marked by leukocytosis and obstructive transaminitis. Computed tomography raised concern for a dilated 14-mm common bile duct with migrated coil mass near the pancreatic head. The patient underwent urgent endoscopic retrograde cholangiopancreatography with cholangioscopy and successful removal of a coil mass measuring approximately 4 × 3 cm without injury to the common bile duct or vascular structures. His pain was relieved, and he was discharged with a common bile duct stent and outpatient follow-up.