Duodenal perforation is an uncommon but potentially fatal complication of pancreatic surgery. We report a 73-year-old man who presented with hematochezia after laparoscopic distal pancreatectomy with splenectomy for pancreatic body cancer, complicated by a postoperative pancreatic fistula that led to gastroduodenal artery bleeding treated with a stent-graft. Contrast-enhanced CT showed active duodenal bleeding with a surrounding hematoma. The bleeding duodenal branch was embolized, and the hematoma was drained percutaneously; a fistulous communication between the periduodenal collection and the duodenal lumen was subsequently demonstrated. Through the drainage tract, an 8-Fr Foley catheter was advanced into the duodenal lumen and its balloon inflated to secure a controlled fistula, while a percutaneous gastrojejunostomy provided distal enteral feeding. The catheter was maintained for approximately 2 months, and the tract was embolized at the time of removal to minimize residual leakage. The patient recovered fully. This case demonstrates the feasibility of staged interventional management for postoperative duodenal perforation when reoperation is not feasible.

Acute SVC syndrome caused by extensive thrombosis requires prompt endovascular intervention. We report a 48-year-old female with colon cancer presenting with massive chemoport-related thrombosis involving the SVC, right atrium (RA), and bilateral brachiocephalic veins. Due to the lack of an embolic protection filter landing zone, we performed a novel plug-assisted thrombectomy (PAT) technique. A 20-mm vascular plug was positioned at the SVC-RA junction as a temporary tethered filter without detachment. Following mechanical thrombectomy, plug retrieval, and adjunctive balloon dilatation, the patient recovered and was discharged on day 12. This case demonstrates the technical feasibility of PAT as a proof-of-concept approach for embolic protection in patients with extensive SVC thrombosis where conventional filter placement is anatomically precluded.