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Published on: March 4, 2016
Duodenocaval fistula from inferior vena cava filter penetration masquerading as lower gastrointestinal bleeding
Lokesh Bathla1, Aru Panwar, Robert J Fitzgibbons
1Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA. bathlalok@gmail.com
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.
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