Context Perforation of interior vena cava filters is uncommon but has been described. We report a case of an interior vena cava filter which appeared to have perforated into the main pancreatic duct causing recurrent pancreatitis. Case report A seventy-six-year-old female with previous interior vena cava filter placement developed recurrent pancreatitis. During one of her hospital admissions for acute pancreatitis, an interior vena cava filter prong was noted to be abutting the duodenal wall at the level of the pancreatic head on computer tomography imaging. Magnetic resonance imaging/cholangiopancreatography revealed multifocal pancreatic duct stricturing. Given her recurrent acute pancreatitis and multiple pancreatic duct strictures, an endoscopic retrograde cholangiopancreatography with pancreatic duct stent placement was performed. During pancreatic duct stent exchange on a subsequent endoscopic retrograde cholangiopancreatography, two interior vena cava filter prongs were noted to have bent in a different orientation during manipulation of the stent. At this time, there was concern for communication between the interior vena cava filter and the pancreatic duct, along with suspicion that this was precipitating her recurrent episodes of pancreatitis. The interior vena cava filter was subsequently removed by interventional radiology, and she has not had any further documented episodes of acute pancreatitis in the 13 months since her interior vena cava filter removal. Conclusions Perforation of interior vena cava filters is a rare cause of recurrent pancreatitis. When noted, the interior vena cava filter should be removed.
Natalie D Cosgrove, Pavan K Kavali, Daniel K Mullady