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A woman aged 47 years presented to the emergency department with symptoms of fever, sudden-onset severe stabbing epigastric pain accompanied by nausea and non-bloody vomiting emesis. The patient had a medical history of recurrent abdominal pain and reflux which was treated with proton pump inhibitors. Owing to recurrent deep vein thrombosis and contraindications to anticoagulants, an inferior vena cava (IVC) filter was implanted 20 years prior. CT scan revealed IVC filter with prongs in the duodenum. Oesophagogastroduodenoscopy revealed a metallic foreign body projecting through the posterior wall of the duodenum, into the lumen, with surrounding erythema and oedema with minimal bleeding at the site of perforation (figure 1).
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