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Duodenal penetration by a Greenfield caval filter
1Department of Vascular Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
The Australian and New Zealand Journal of Surgery
|December 1, 1991
Summary
A Greenfield filter migrated and penetrated the duodenum 6 years after implantation. This rare complication caused severe symptoms, which resolved after surgical filter removal.
Area of Science:
- Vascular surgery
- Gastroenterology
- Medical device complications
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
- Greenfield filters are a type of IVC filter with a low reported complication rate.
- Device migration and perforation are known, albeit rare, complications of IVC filters.
Observation:
- A 77-year-old woman presented with severe diarrhea, night sweats, and weight loss 6 years post-Greenfield filter insertion.
- Initial abdominal X-rays showed a deformed and angulated Greenfield filter.
- Cavography and CT scans confirmed the filter had penetrated the inferior vena cava and duodenum.
Findings:
- The Greenfield filter had migrated from the IVC and perforated the duodenal wall.
- The patient's symptoms resolved completely following surgical removal of the perforated filter.
- This case highlights a rare but significant complication of long-term Greenfield filter placement.
Implications:
- Physicians should consider rare complications like duodenal penetration in patients with a history of IVC filter placement presenting with unexplained gastrointestinal symptoms.
- Advanced imaging is crucial for diagnosing filter migration and perforation.
- Surgical intervention may be necessary for managing severe complications associated with IVC filters.