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IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain
Patient: Female, 67 Final Diagnosis: IVC filter perforation through duodenum Symptoms: Abdominal pain Medication: — Clinical Procedure: Esophagogastroduodenoscopy Specialty: Gastroenterology and Hepatology OBJECTIVE: Challenging differential diagnosis BACKGROUND: The number of IVC filter-related com...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447199/ https://www.ncbi.nlm.nih.gov/pubmed/25979859 http://dx.doi.org/10.12659/AJCR.893541 |
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author | Jehangir, Asad Rettew, Andrew Shaikh, Bilal Bennett, Kyle Jehangir, Qasim Qureshi, Anam Arshad, Sharjeel Spiegel, Adam |
author_facet | Jehangir, Asad Rettew, Andrew Shaikh, Bilal Bennett, Kyle Jehangir, Qasim Qureshi, Anam Arshad, Sharjeel Spiegel, Adam |
author_sort | Jehangir, Asad |
collection | PubMed |
description | Patient: Female, 67 Final Diagnosis: IVC filter perforation through duodenum Symptoms: Abdominal pain Medication: — Clinical Procedure: Esophagogastroduodenoscopy Specialty: Gastroenterology and Hepatology OBJECTIVE: Challenging differential diagnosis BACKGROUND: The number of IVC filter-related complications has increased with their growing utilization; however, IVC filter perforation of the duodenum is rare. It can manifest with nonspecific abdominal pain, gastrointestinal bleeding, cava-duodenal fistula, or small bowel obstruction. CASE REPORT: A 67-year-old female presented with several years of right upper quadrant abdominal pain which was exacerbated by movement and food intake. She had a history of hepatic steatosis, cholecystectomy, and multiple DVTs with inferior vena cava filter placement. Physical exam was unremarkable. Laboratory tests demonstrated elevated alkaline phosphatase and transaminases. Esophagogastroduodenoscopy revealed a thin metallic foreign body embedded in the duodenal wall and protruding into the duodenal lumen with surrounding erythema and edema, but no active hemorrhage. Further evaluation with non-contrast CT scan revealed that one of the prongs of her IVC filter had perforated through the vena cava wall into the adjacent duodenum. Exploratory laparotomy was required for removal of the IVC filter and repair of the vena cava and duodenum. Her post-operative course was uneventful. CONCLUSIONS: In patients with history of IVC filter placement with non-specific abdominal pain, a high clinical suspicion of IVC filter perforation of the duodenum should be raised, as diagnosis may be challenging. CT scan and EGD are valuable in the diagnosis. Excellent outcomes have been reported with open surgical filter removal. Low retrieval rates of IVC filters have led to increased complications; hence, early removal should be undertaken as clinically indicated. |
format | Online Article Text |
id | pubmed-4447199 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-44471992015-06-09 IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain Jehangir, Asad Rettew, Andrew Shaikh, Bilal Bennett, Kyle Jehangir, Qasim Qureshi, Anam Arshad, Sharjeel Spiegel, Adam Am J Case Rep Articles Patient: Female, 67 Final Diagnosis: IVC filter perforation through duodenum Symptoms: Abdominal pain Medication: — Clinical Procedure: Esophagogastroduodenoscopy Specialty: Gastroenterology and Hepatology OBJECTIVE: Challenging differential diagnosis BACKGROUND: The number of IVC filter-related complications has increased with their growing utilization; however, IVC filter perforation of the duodenum is rare. It can manifest with nonspecific abdominal pain, gastrointestinal bleeding, cava-duodenal fistula, or small bowel obstruction. CASE REPORT: A 67-year-old female presented with several years of right upper quadrant abdominal pain which was exacerbated by movement and food intake. She had a history of hepatic steatosis, cholecystectomy, and multiple DVTs with inferior vena cava filter placement. Physical exam was unremarkable. Laboratory tests demonstrated elevated alkaline phosphatase and transaminases. Esophagogastroduodenoscopy revealed a thin metallic foreign body embedded in the duodenal wall and protruding into the duodenal lumen with surrounding erythema and edema, but no active hemorrhage. Further evaluation with non-contrast CT scan revealed that one of the prongs of her IVC filter had perforated through the vena cava wall into the adjacent duodenum. Exploratory laparotomy was required for removal of the IVC filter and repair of the vena cava and duodenum. Her post-operative course was uneventful. CONCLUSIONS: In patients with history of IVC filter placement with non-specific abdominal pain, a high clinical suspicion of IVC filter perforation of the duodenum should be raised, as diagnosis may be challenging. CT scan and EGD are valuable in the diagnosis. Excellent outcomes have been reported with open surgical filter removal. Low retrieval rates of IVC filters have led to increased complications; hence, early removal should be undertaken as clinically indicated. International Scientific Literature, Inc. 2015-05-16 /pmc/articles/PMC4447199/ /pubmed/25979859 http://dx.doi.org/10.12659/AJCR.893541 Text en © Am J Case Rep, 2015 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License |
spellingShingle | Articles Jehangir, Asad Rettew, Andrew Shaikh, Bilal Bennett, Kyle Jehangir, Qasim Qureshi, Anam Arshad, Sharjeel Spiegel, Adam IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain |
title | IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain |
title_full | IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain |
title_fullStr | IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain |
title_full_unstemmed | IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain |
title_short | IVC Filter Perforation through the Duodenum Found after Years of Abdominal Pain |
title_sort | ivc filter perforation through the duodenum found after years of abdominal pain |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447199/ https://www.ncbi.nlm.nih.gov/pubmed/25979859 http://dx.doi.org/10.12659/AJCR.893541 |
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