Symptomatic duodenal perforation by a Bird's Nest vena cava filter

This case describes a patient with a permanent Bird's Nest inferior vena cava filter in the setting of spinal cord injury and paraplegia who presented with epigastric pain resulting from duodenal perforation of his filter. After confirming that the patient was stable hemodynamically with normal laboratory values, he underwent open exploration with trimming of the extraluminal struts and wires, leaving the intact filter in place, with resolution of his pain. Although percutaneous removal of inferior vena cava filters is preferred for retrievable filters, this case demonstrates the safety and efficacy of open surgical management for permanent filters, not designed for retrieval.