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• W2072143925 abstract "Un cas de performation de la troisième portion du duodénum par les crochets d'un filtre de Greenfield mis en place quatre ans auparavant dans les suites d'une embolie pulmonaire est rapporté. La patiente, âgée de 66 ans, était hospitalisée pour altération de l'état général, douleurs épigastriques, vomissements, déshydratation extracellulaire avec insuffisance rénale. Sur la radiographie de l'abdomen sans préparation, le filtre cave était incliné de 15 degrés vers la gauche et son diamètre d'ouverture était de 28 mm. L'endoscopie digestive haute permettait la découverte d'une perforation de la face postérieure du troisième duodénum par l'un des bras du dispositif. La scanographie abdominale confirmait l'existence de la perforation. Les différentes complications tardives de l'interruption de la veine cave inférieure par des filtres sont rappelées. Les radiographies de l'abdomen sans préparation permettent le contrôle répété de la position du filtre, alors que la tomodensitométrie apporte une aide essentielle au diagnostic des complications intra et extravasculaires. A case is reported of a duodenal perforation by a Kimray-Greenfield filter hook in a 66-year-old female patient. This device had been inserted four years before, after a pulmonary embolism. The patient presented with epigastric pain, vomiting and extracellular dehydration with renal failure. A plain abdominal film showed the filter to be tilted 15 degrees to the left, with an opening 28 mm wide. Various investigations were carried out, none of which providing a satisfactory diagnosis. Steroid treatment (1 mg · kg−1 · day−1 of prednisone) was started before admission to intensive care. Only at that time gastroduodenoscopy showed on of the filter's hooks jutting through the duodenal wall. This perforation was located in the posterior wall of the third part of the duodenum, and was associated with an ulcer of the mucosa facing this hook. The diagnosis was confirmed by an abdominal CT scan. The hook was cut and the perforation sealed off during a first laparotomy. Twenty-six days later, the patient developed intestinal obstruction due to a haematoma of the jejunal wall. She later had a cerebrovascular accident, with status epilepticus and deep coma. She died four months after her admission. The late complications of vena caval filters are discussed. The position of these devices should be regularly checked by a plain abdominal film. Abdominal CT scanning is a useful investigation for the diagnosis of intra and extravascular complications." @default.
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• W2072143925 date "1993-01-01" @default.
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• W2072143925 title "Perforation duodénale par les crochets d'un filtre de Kimray-Greenfield" @default.
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• W2072143925 doi "https://doi.org/10.1016/s0750-7658(05)80879-2" @default.
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