The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Case Report

The Greenfield Filter as a Potential Hazard to the Operating Surgeon

Authors: Ruben Gomez, MD, PHD, Walter Salwen, MD, Marc D. Basson, MD, PHD

Abstract

The Greenfield filter and similar devices are placed in the vena cava of patients who have contraindications to anticoagulation, but who would otherwise be at risk of pulmonary embolism without such anticoagulation. Injury to a health care worker from one of these devices has been reported in the case of a pathologist performing a necropsy. To the author’s knowledge, injury or near-injury to a member of the surgical team during operation has not been reported in the literature. The authors report on a near-miss injury from such a device to the surgical first assistant during the performance of a pancreaticoduodenectomy. Simple guidelines to avoid similar injuries are provided.

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References

1. Abraham JL, Greenfield LJ. Hazard to pathologists and anatomists from vena-caval (Greenfield) filters.Lancet 1995;346:1100.
 
2. Woodward EB, Farber A, Wagner WH, et al. Delayed retroperitoneal arterial hemorrhage after inferior vena cava (IVC) filter insertion: case report and literature review of caval perforations by IVC filters. Ann Vasc Surg 2000;16:193–196.
 
3. Jackson SAL, Kennedy RJ, Hakam AG, et al. Delayed transcaval renal penetration of a Greenfield filter presenting as symptomatic hydronephrosis. J Urol 2002;167:1778–1779.
 
4. O’Brian DS. Patterns of occupational hand injury in pathology. The interaction of blades, needles, and the dissector’s digits. Arch Pathol Lab Med 1991;115:610–613.
 
5. Ippolito G. Scalpel injury and HIV infection in a surgeon. Lancet 1996; 347:1042.
 
6. Gerberding JL, Littell C, Tarkington A, et al. Risk of exposure of surgical personnel to patient’s blood during surgery at San Francisco General Hospital. New Engl Journ of Med 1990;322:1788–1793.