Bird's Nest Inferior Vena Caval Filter Migration into the Duodenum: A Rare Cause of Upper Gastrointestinal Bleeding

Abstract

This event reinforces the need to monitor patients with IVC filters over the long term, preferably using CT scanning, and to consider filter migration as a possible cause of upper gastrointestinal bleeding.

A systematic review of symptomatic duodenal perforation by inferior vena cava filters

“…A summary table containing data on clinical presentation and filter characteristics is provided in Table I. [5][6][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Imaging workup was performed in all patients with abdominal pain or GI bleed who had previous IVC filter placement. Three different imaging modalities were completed before any intervention in 9 patients (43%).…”

Penetration of a fractured Bird's Nest filter strut into the liver parenchyma: report of two cases

“…Other complications will be detected early or late after successful placement. Among this type of complications, the most frequently reported ones are insufficient clot trapping resulting in recurrent pulmonary embolism, IVC obstruction, lower extremity venous insufficiency and finally, a number of late complications directly related to the filter device itself, such as: strut erosion through the IVC wall (5) (or in extreme condition through the aorta resulting in a bleeding aortic pseudoaneurysm [9]), late filter migration, strut fracture and strut penetration of the IVC wall with further migration of the fractured strut into one of the surrounding organs of the IVC (the peritoneum [10], the duodenum [6], the pancreas [11], the right ureter [12] or even the right atrium, and beyond the pulmonary arteries after cephalad migration [8]). …”

Hemorrhagic Shock with Delayed Retroperitoneal Hemorrhage After Deployment of an Inferior Vena Cava Filter: Report of a Case

“…[4][5][6] While most of these developments are asymptomatic, some are associated with severe sequelae. Larger series have shown that approximately 10% of penetrations are actually symptomatic and require therapeutic intervention, 7 including incidents of duodenal perforation, 8,9 aortic penetration, 10,11 and ureteral injury. 12,13 In particular, retroperitoneal hemorrhaging is one of the most serious complications associated with IVC penetration.…”