Acute renal failure due to aortocaval fistula

Ramón, Marta López

doi:10.1093/ndt/13.5.1268

Cited by 13 publications

(3 citation statements)

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“…( 2 ) Ultimately, as was the case for this patient, the acute combination of decreased inflow with obstructed outflow causes rapid renal failure. In a presentation mimicking cardiorenal syndrome, in the case of a massive fistula, compensatory mechanisms are overwhelmed with subsequent signs of acute heart failure and renal impairment ( 3 ). Our patient demonstrated a dramatic presentation of this physiology as well as an equally dramatic improvement with the repair.…”

Section: Discussionmentioning

confidence: 99%

Ruptured Iliac Arteriovenous Fistula Presenting With Thigh Pain and Swelling: Case Report

et al. 2022

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The presentation of abdominal arteriovenous fistulas is classically described as a triad of a pulsatile abdominal mass with a bruit, high-output heart failure, and regional venous hypertension with primarily open operative therapy. In the following case, we present the treatment of a patient who arrived with acute right heart failure and renal failure due to an arteriovenous fistula and who was successfully treated with endovascular repair.

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Section: Discussionmentioning

confidence: 99%

Ruptured Iliac Arteriovenous Fistula Presenting With Thigh Pain and Swelling: Case Report

et al. 2022

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“…The mechanism of the spontaneous formation of an arteriovenous fistula involves the combination of high arterial wall tension and adventitial inflammation, leading to an adhesion and an erosion of the arterial wall into the vein wall [ 4 ]. In cases of aortocaval fistulas, the high blood flow and venous hypertension may be responsible for pelvic vein arterialization and engorgement, which can cause asymmetric lower extremity edema [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

The Physical Examination Does Matter: A Case of Spontaneous Aortocaval Fistula

Desai

Akbashev

Rubinsztain

et al. 2017

Cureus

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“…Spontaneous aortocaval fistula formation is reported to occur in averagely 4% of ruptured abdominal aortic aneurysms [5,6,[10][11][12][13] . The condition was first described in 1831 by Syme [14] .…”

Section: Discussionmentioning

confidence: 99%

Multi-organ failure secondary to an aortocaval fistula-when should it be suspected?

Medani

Walker

Leavey

2015

CRIM

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Spontaneous aortocaval fistula (ACF) is a rare, life threatening complication of abdominal aortic aneurysms (AAA) which is seldom suspected clinically. We report a case of progressive multi-organ failure secondary to an ACF wherein a delayed diagnosis was followed by a successful outcome. A 67-year-old man presented with dyspnoea on exertion, cough, and night sweats for three weeks. Initial investigations showed type 1 respiratory failure and mild renal impairment. He was treated for a suspected respiratory tract infection and fluid overload but antibiotic and diuretic therapies were ineffective. Within the following 36 hours he developed progressive azotemia and acute liver failure. He had physical signs of predominantly right-sided heart failure with preserved left ventricular systolic function on echocardiogram. Abdominal ultrasound and a non-contrast computed tomography (CT) revealed mild hepatomegaly, a 10 cm AAA with no evident leak and unremarkable kidneys. Oliguria and metabolic acidosis ensued with rapid deterioration of renal function and hypotension necessitating continuous veno-venous hemofiltration with inotropic support. Hepatic and renal function improved within a week of intensive care therapy but signs of volume overload persisted. A contrast abdominal CT demonstrated an ACF, which was successfully managed by endovascular stent-grafting. This case highlights the importance of being alert to the haemodynamic consequences of aortocaval rupture particularly in the presence of a large AAA in a patient presenting with unexplained organ failure and hyperkinetic shock. Optimisation of supportive care impacts favourably on the perioperative course and overall prognosis of this rare condition.

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Acute renal failure due to aortocaval fistula

Cited by 13 publications

References 1 publication

Ruptured Iliac Arteriovenous Fistula Presenting With Thigh Pain and Swelling: Case Report

Ruptured Iliac Arteriovenous Fistula Presenting With Thigh Pain and Swelling: Case Report

The Physical Examination Does Matter: A Case of Spontaneous Aortocaval Fistula

Multi-organ failure secondary to an aortocaval fistula-when should it be suspected?

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