Choledochoduodenal fistula caused by migration of endoclip after laparoscopic cholecystectomy

Figure 1 Plain abdominal radiograph showed metal endoclips (arrow) in the right upper quadrant area.

Figure 2 Magnetic resonance cholangiography showed marked dilatation of biliary duct and stenosis of the common bile duct at the hepatic duct confluence (arrow), which was close to the duodenum.

Figure 3 Endoscopic image of the duodenum showed yellowish bile acid (arrow) leaking from a papillary orifice at the first part of duodenum wall.

Figure 4 Computed tomography showed a mass on the duodenal wall (arrow), and linear, highly dense lesions both in the mass (A, arrow) and in the hepatic duct confluence (B, arrow) with dilated hepatic ducts.