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Case Reports
. 2025 Mar 8;11(3):101780.
doi: 10.1016/j.jvscit.2025.101780. eCollection 2025 Jun.

Duodenal-caval fistula from eroding inferior vena cava stent requiring explant and duodenal repair

Karissa M Wang  1 , Nicolas A Stafforini  1 , Jonathan G Sham  2 , Jake F Hemingway  1
Affiliations
Case Reports

Duodenal-caval fistula from eroding inferior vena cava stent requiring explant and duodenal repair

Karissa M Wang et al. J Vasc Surg Cases Innov Tech. .

Abstract

A 36-year-old male, with a prior history of an abdominal gunshot wound requiring duodenojejunostomy and inferior vena cava (IVC) repair, complicated by subsequent IVC occlusion requiring stent placement, presented 13 years after his initial injuries with abdominal pain and septic shock secondary to erosion of the IVC stent into the duodenum, forming a duodenal-caval fistula, resulting in bacteremia and fungemia. He underwent successful partial IVC stent explant and duodenal repair. Although rare, the possibility of IVC stent erosion into adjacent structures should be considered as a potential complication following IVC stent reconstruction in reoperative fields.

Keywords: Duodenal fistula; Stent erosion; Vena cava fistula.

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Conflict of interest statement

None.

Figures

Fig 1
Fig 1
Computerized tomography scan demonstrating inferior vena cava (IVC) stent components protruding beyond the IVC (yellow arrows) in proximity to the small bowel in axial (left) and sagittal (right) views. Also seen is thrombus within the IVC stent.
Fig 2
Fig 2
Esophagogastroduodenoscopy revealing a metallic foreign body in the second portion of the duodenum, eroding into the duodenal wall. Surrounding inflammation was visualized, but no active hemorrhage was seen.
Fig 3
Fig 3
Antimesenteric portion of the second portion of the duodenum (yellow star) densely adherent to the underlying inferior vena cava (IVC) and stent (yellow arrow).
Fig 4
Fig 4
Penetrating Z-stent and exposed Wallstent struts with caval defect seen. Duodenum is retracted by white gloved hands.
Fig 5
Fig 5
Removed stent struts.
Fig 6
Fig 6
Post-stent removal. Small feeding tube is within the duodenal ampulla for orientation (yellow arrow).
Fig 7
Fig 7
Transverse duodenal repair (arrows) with retroperitoneal soft tissue coverage (star).
See this image and copyright information in PMC

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