S Botsios1, R Erhart, G Walterbusch. 1. Klinik für Herz-Thorax-Gefässchirurgie, St.-Johannes Hospital Dortmund. botsios@arcor.de
Abstract
HISTORY AND CLINICAL FINDINGS: A 77-year-old woman was admitted to a nearby hospital because of acute upper gastrointestinal bleeding and collapse. A Greenfield caval filter had been implanted nine years before admission because of pulmonary embolism. INVESTIGATIONS: Gastroduodenoscopy showed two hooks of the caval filter having penetrated the duodenum. The diagnosis was confirmed by an abdominal CT scan. TREATMENT AND COURSE: The patient was transferred to our hospital for surgical removal of the cava filter, which was done through the right-flank retroperitoneal approach. She had an uneventful recovery and was discharged from the hospital on the 7th postoperative day. CONCLUSIONS: Acute upper gastrointestinal bleeding caused by by a Greenfield cava filter perforating the duodenum is an extremely rare complication. But in case of acute gastrointestinal bleeding in a patient with an implanted caval filter or vascular prosthesis this should be considered and the filter removed surgically.
HISTORY AND CLINICAL FINDINGS: A 77-year-old woman was admitted to a nearby hospital because of acute upper gastrointestinal bleeding and collapse. A Greenfield caval filter had been implanted nine years before admission because of pulmonary embolism. INVESTIGATIONS: Gastroduodenoscopy showed two hooks of the caval filter having penetrated the duodenum. The diagnosis was confirmed by an abdominal CT scan. TREATMENT AND COURSE: The patient was transferred to our hospital for surgical removal of the cava filter, which was done through the right-flank retroperitoneal approach. She had an uneventful recovery and was discharged from the hospital on the 7th postoperative day. CONCLUSIONS:Acute upper gastrointestinal bleeding caused by by a Greenfield cava filter perforating the duodenum is an extremely rare complication. But in case of acute gastrointestinal bleeding in a patient with an implanted caval filter or vascular prosthesis this should be considered and the filter removed surgically.