A penetrating inferior vena caval filter...
BACKGROUND
The concept of vena caval interruption was first described by Armand Trousseau in 1865 [HANN CL. STREIFF MB. The role of vena caval filters in the management of venous thromboembolism. Blood Rev 2005;19(4):179-202]. Methods described have included surgical ligation of the inferior vena cava (IVC) to the development of percutaneous inferior vena caval filters which have been, up until recently, permanently placed in the vessel. These devices are not without risk. We describe a case of penetration of the duodenum by a standard stainless steel Greenfield vena caval filter.


METHODS
An 83 year old woman presented with vague epigastric discomfort. She was noted to have intermittent globally deranged liver function tests and was investigated accordingly. Investigations included an endoscopic retrograde cholangio-pancreatography (ERCP) which revealed an inferior vena cava filter penetrating the wall of the small bowel.


CONCLUSIONS
We describe this unique presentation of a penetrating vena caval filter and suggest that a clinician may be inclined to consider a simple endoscopy on occasions when this complication/diagnosis is considered.
DuraiRaj
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R
Department of Surgery, Prince of Wales Hospital, Randwick, Sydney, New South Wales, Australia. dr_raj7777@hotmail.com
Fogarty
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D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004386:Duodenum / Q000293:injuries*; D005260:Female; D006801:Humans; D014057:Tomography, X-Ray Computed; D016306:Vena Cava Filters / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology*