title: Surgical removal of a Günther Tulip filter with symptomatic caval penetration after unsuccessful percutaneous retrieval.
abstract: We report a case involving the surgical removal of a Günther Tulip filter with symptomatic caval penetration after an unsuccessful attempt at percutaneous retrieval in a 32-year-old man with recurrent deep vein thrombosis. He presented with acute right flank pain a day after the attempted retrieval of the filter. An abdominal radiograph before surgical removal of the filter showed tilting and splaying of the filter, which was suggestive of caval penetration. Contrast-enhanced computerized tomography confirmed caval penetration of the filter legs into the retroperitoneal space, right renal vein, and duodenum associated with a small retroperitoneal fluid collection. Surgical removal of the filter by a transperitoneal approach resulted in resolution of the flank pain.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jeong Kye
authors.initials: JK
authors.lastname: Hwang
authors.forename: Ji Il
authors.initials: JI
authors.lastname: Kim
authors.forename: Sang Dong
authors.initials: SD
authors.lastname: Kim
authors.forename: Kyung J
authors.initials: KJ
authors.lastname: Cho
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
mesh_terms: D000328:Adult; D003287:Contrast Media; D020878:Device Removal; D004386:Duodenum / Q000293:injuries / Q000601:surgery; D021501:Flank Pain / Q000209:etiology; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D008297:Male; D011474:Prosthesis Design; D012008:Recurrence; D012082:Renal Veins / Q000293:injuries / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016306:Vena Cava Filters / Q000009:adverse effects*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D020246:Venous Thrombosis / Q000628:therapy*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
chemical_list: D003287:Contrast Media