Percutaneous transhepatic embolisation of multisegmental bile leak using a combined Histoacryl–Lipiodol mixture

Bile leakage is a serious complication that can lead to life-threatening conditions if not promptly addressed. We present a rare case of a 38-year-old male patient who sustained a liver laceration due to a gunshot injury, resulting in a multisegmental bile leak. Despite percutaneous transhepatic biliary drainage (PTBD), a persistent bile leak was observed. Selective embolisation was performed by interventional radiology via microcatheterisation of the affected peripheral biliary branches, using a mixture of Lipiodol and Histoacryl. The patient showed complete clinical recovery, and the bile leak resolved during follow-up. This case highlights a minimally invasive and effective treatment alternative for refractory bile leaks unresponsive to PTBD, potentially reducing the need for surgical intervention and its associated risks.