Asymptomatic arterio-biliary fistula after transarterial chemoembolizationof metastatic liver tumors

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.