[Acute gastrointestinal bleeding caused by perforation of a Greenfield caval filter into the duodenum].

History and Clinical Findings: A 77-year-old woman was admitted to a nearby hospital because of acute upper gastrointestinal bleeding and collapse. A Greenfield caval filter had been implanted nine years before admission because of pulmonary embolism.
Investigations: Gastroduodenoscopy showed two hooks of the caval filter having penetrated the duodenum. The diagnosis was confirmed by an abdominal CT scan.
Treatment and Course: The patient was transferred to our hospital for surgical removal of the cava filter, which was done through the right-flank retroperitoneal approach. She had an uneventful recovery and was discharged from the hospital on the 7th postoperative day.
Conclusions: Acute upper gastrointestinal bleeding caused by by a Greenfield cava filter perforating the duodenum is an extremely rare complication. But in case of acute gastrointestinal bleeding in a patient with an implanted caval filter or vascular prosthesis this should be considered and the filter removed surgically.