Migration of an inferior vena cava prosthesis into the duodenum (with video) - 12/04/25
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Highlights |
• | A PTFE or Dacron vascular prosthesis can be progressively embedded in the intestine at the point of contact. |
• | Symptoms vary, but the most frequent are occlusion and recurrent sepsis. Diagnosis is based on CT-scan and endoscopy. |
• | Removal of the prosthesis, endoscopically or surgically, can be very simple or complex. |
• | The best preventive treatment is to interpose an omentum flap between the intestine and the prosthesis during the initial procedure. |
Abstract |
In 2012, a 42-year-old man underwent a right hepatectomy with replacement of the inferior vena cava using a PolyTetraFluoroEthylene (PTFE) prosthesis for hepatocellular carcinoma on a healthy liver. Seven years later, the patient was treated with antibiotics for recurrent bacterial infections. Preoperative computed tomography scanner revealed a thombotic prosthesis into the duodenum. Venous blood flow bypassed the prosthesis via the enlarged azygos system. We described surgical procedure with a video and reviewed 11 published cases. Our recommendation is to systematically interpose an omentum flap between protheses and surrounding digestive structures whenever possible.
Le texte complet de cet article est disponible en PDF.Keywords : vascula prosthesis, hepatectomy, PTFE, migration, inferior vena cava, infectious disease
Plan
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