Arterio-biliary fistula is a rare clinical condition resulting from various
causes such as iatrogenic injury and ischemic change of the bile duct. Ser
ious clinical symptoms occur due to the shunting of high-pressure blood fro
m the hepatic artery into the bile duct. Here we report a case of arterio-b
iliary fistula demonstrated by angiographic examinations. The communication
appeared after repeat transarterial chemoembolization of metastatic liver
tumors. The interesting point of this case was that the patient did not hav
e any obvious clinical symptoms related to the fistula. The mechanisms resp
onsible for this rare manifestation are discussed.