The Teaching Point

Careful manipulation of the IVC during abdominal surgery in the presence of an IVC filter is crucial to avoid IVC filter-related penetration. Retrieving the IVC filter temporarily before the operation and performing filter redeployment after surgery is still an option. The presented case highlights the possibility of ureteral irritation and scarring secondary to prolonged penetration of the ureter by an IVC filter resulting in ureteral obstruction.






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From the manuscript

Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury

Free full text article: Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury

Abstract
We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple`s pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure.






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1. IVC filter

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