title: Successful percutaneous thrombectomy of an infected vena-caval thrombus due to a toothpick.
abstract: We report a case of a 25-year-old Caucasian female with a septic thrombosis in the inferior vena cava (IVC) which contained a toothpick. She was admitted with fever and abdominal pain for 2 weeks. Computed tomography scan showed thrombus with air density in the suprarenal IVC. However, there was no evidence of duodenocaval fistula. Because of the patient's reluctance for surgery, endovascular therapy was tried. A partially-deployed nitinol stent was used as a filter, and aspiration thrombectomy was performed. Unexpectedly, a toothpick was retrieved within the stent. Anticoagulants and antibiotics were administered. A follow-up computed tomography after 2 months showed total resolution of the residual thrombus.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seong-Yup
authors.initials: SY
authors.lastname: Kim
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Myoung-Don
authors.initials: MD
authors.lastname: Oh
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: Seung-Kee
authors.initials: SK
authors.lastname: Min
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002176:Candida albicans / Q000302:isolation & purification; D057510:Endovascular Procedures; D005260:Female; D005334:Fever / Q000209:etiology; D005548:Foreign-Body Migration / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D010690:Phlebography / Q000379:methods; D018805:Sepsis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries / Q000382:microbiology; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D000935:Antifungal Agents