Migration of an inferior vena cava prosthesis into the duodenum (with video)

• 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. 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 thrombotic prosthesis into the duodenum. Venous blood flow bypassed the prosthesis via the enlarged azygos system. We described our surgical procedure to remove the prosthesis with a video and reviewed 11 published cases. Our recommendation is to systematically interpose an omentum flap between prostheses and surrounding digestive structures whenever possible.