Small Bowel Volvulus in a Quadriplegic: A Rare Complication of the Simon Nitinol Inferior Vena Cava Filter

Abstract

The advent and use of inferior vena cava (IVC) filters have reduced the overall incidence of pulmonary embolism in hospitalized patients, but are not without potential complications. With the exponential increase in the utilization of IVC filters over the past two decades, it is important to consider the use of retrievable filters, where indicated, in order to potentially reduce long-term IVC filter-related complications. We report a rare case of small bowel volvulus due to IVC perforation by a Simon Nitinol filter strut in a quadriplegic patient 4 years after IVC filter insertion.

Inferior vena cava filter fracture with strut migration on CT with volume rendering

“…Penetration of the IVC is most often benign but can result in aortic penetration and pancreatitis when the filter comes in contact with nearby structures [ 9 , 10 ]. Filter perforations can also extend into the peritoneal cavity [ 11 , 12 ]. In the case presented we believe the fractured strut penetrated the IVC into the peritoneal cavity and settled in the right lower quadrant.…”