title: Duodenocaval fistula from inferior vena cava filter penetration masquerading as lower gastrointestinal bleeding.
abstract: Asymptomatic penetration of the inferior vena cava (IVC) wall with retrievable filters is not uncommon. Occasionally, this can be a cause for morbidity, and rarely for mortality. We present a case of duodenocaval fistula, secondary to penetration from a strut of retrievable IVC filter that presented as lower gastrointestinal bleeding and discuss the subsequent management. Although newer generation retrievable filters provide a longer time for retrieval, they are associated with an increased incidence of IVC wall penetration, caudal migration, and occasionally symptomatic presentation, thereby necessitating surgical intervention. Close follow-up is warranted, and prompt retrieval of such devices should be done when their use is no longer indicated.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA. bathlalok@gmail.com
authors.forename: Lokesh
authors.initials: L
authors.lastname: Bathla
authors.forename: Aru
authors.initials: A
authors.lastname: Panwar
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fitzgibbons
authors.forename: Marcus
authors.initials: M
authors.lastname: Balters
mesh_terms: D000368:Aged; D020878:Device Removal; D013505:Digestive System Surgical Procedures; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004384:Duodenoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014656:Vascular Surgical Procedures; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016306:Vena Cava Filters / Q000009:adverse effects*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery