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下腔静脉滤器穿透导致十二指肠腔静脉瘘,伪装为下消化道出血。

Duodenocaval fistula from inferior vena cava filter penetration masquerading as lower gastrointestinal bleeding.

作者信息

Bathla Lokesh, Panwar Aru, Fitzgibbons Robert J, Balters Marcus

机构信息

Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA.

出版信息

Ann Vasc Surg. 2011 Nov;25(8):1140.e7-11. doi: 10.1016/j.avsg.2011.03.015. Epub 2011 Aug 11.

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.

摘要

可回收滤器无症状穿透下腔静脉(IVC)壁的情况并不少见。偶尔,这可能导致发病,极少情况下会导致死亡。我们报告一例十二指肠腔静脉瘘病例,继发于可回收IVC滤器支柱的穿透,表现为下消化道出血,并讨论后续治疗。尽管新一代可回收滤器提供了更长的回收时间,但它们与IVC壁穿透、尾端迁移的发生率增加有关,偶尔还会出现症状性表现,因此需要手术干预。有必要进行密切随访,当不再需要使用此类装置时,应及时将其取出。

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