Aorto-Caval Fistula - an Uncommon Complication of Infrarenal Aortic Aneurysms

Schmidt, Roland; Bruns, C.; Walter, Michael; Erasmi, H

doi:10.1055/s-2007-1016489

Cited by 65 publications

(70 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 Besides atherosclerotic aneurysms, which represent the majority, other causes are syphilitic, mycotic aneurysms secondary to Marfan's syndrome, Ehlers-Danlos syndrome, Takayasu arteritis, 4-7 after surgery for herniated lumbar disc 8 and secondary to abdominal penetrating or, more rarely, blunt traumas. 9,10 Many series including a small number of cases report diagnostic difficulty.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Aneurisma ilíaco associado a fístula arteriovenosa

Pinto

Júnior²,

Lopes

et al. 2007

J. vasc. bras.

View full text Add to dashboard Cite

Rupture of aortoiliac aneurysms into the iliac vein or vena cava is an uncommon complication. Many signs and symptoms develop as a result of venous hypertension, which makes preoperative diagnosis difficult, such as leg edema, dyspnea, hematuria, signs of renal or cardiac insufficiency. Abdominal bruit, associated with pulsatile mass and abdominal pain, is the key for clinical diagnosis. Preoperative recognition of arteriovenous fistula is important for surgical planning. We report a case of right internal and common iliac artery aneurysm associated with fistula into the common iliac vein. Initial symptoms were right leg edema and dyspnea, which induced to the incorrect diagnosis of deep vein thrombosis.Keywords: Iliac aneurysm, arteriovenous fistula, ruptured aneurysm. RESUMOA ruptura dos aneurismas aorto-ilíacos para a veia ilíaca ou veia cava é uma complicação pouco comum. A hipertensão venosa leva a vários sinais e sintomas, o que dificulta o diagnóstico pré-operatório, tais como edema do membro inferior, dispnéia, hematúria, sinais de insuficiência renal ou cardíaca. Sopro abdominal é a chave do diagnóstico clínico, associado à massa pulsátil e dor abdominal. O reconhecimento da fístula arteriovenosa no pré-operatório é importante para o planejamento cirúrgico. Relatamos um caso de aneurisma da artéria ilíaca comum e interna direita associado a fístula para veia ilíaca comum, cursando, inicialmente, com edema do membro inferior direito e dispnéia, o que levou ao diagnóstico incorreto de trombose venosa profunda. Palavras-chave:Aneurisma ilíaco, fístula arteriovenosa, aneurisma roto.

show abstract

Section: Discussionmentioning

confidence: 99%

“…1,2 We report a case of of common iliac and right internal artery aneurysm with fistula into the common iliac vein, whose initial presentation was right lower limb (RLL) edema and dyspnea, causing diagnostic confusion with deep venous thrombosis and pulmonary embolism.…”

Section: Introductionmentioning

confidence: 99%

Aneurisma ilíaco associado a fístula arteriovenosa

Pinto

Júnior²,

Lopes

et al. 2007

J. vasc. bras.

View full text Add to dashboard Cite

show abstract

“…Aorto-caval fistula (ACF) is a rare entity, complicating about 0.2-6.04% of all abdominal aortic aneurysms (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…Before wide implementation of spiral and multislice computed tomography (CT), some studies reported about 75% of preoperatively undiagnosed cases of ACF (1). Specific signs of ACF on CT enable the prompt and accurate diagnosis (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Aorto-caval fistula clinically presenting as left renal colic Findings of multislice computed tomography

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Aortocaval fistula is a rare entity, complicating about 0.2-0.04 % of all abdominal aortic aneurysms [1,2]. Rare causes include mycotic aneurysm, lues, and disorders of connective tissue, such as the Ehlers-Danlos and Marfan syndromes [3].…”

mentioning

confidence: 99%

Aortocaval fistula

et al. 2014

View full text Add to dashboard Cite

A 71-year-old man with a history of diabetes and coronary artery disease, was admitted to the emergency department (ED) with a 4-h history of left-sided abdominal, leg and scrotal pain. He was taking insulin and antiplatelet therapy. Upon arrival at the ED, the patient was responsive, hemodynamically stable, and complaining of abdominal pain. The vital signs were: heart rate 130 beats/min, right arm blood pressure 120/75 mmHg, temperature 37°C and respiratory rate 26 breaths/min. Percutaneous oxygen saturation was 98 % on room air. The lung sounds were clear and symmetrical with no wheezes or crackles; the heart beats were regular without murmurs: the femoral pulses were reduced on the left side, and the extremities were moist and cold with hypoperfusion.A bedside ultrasound study performed by the emergency physician showed an infrarenal abdominal aortic aneurysm (AAA 6.9 9 6.2 cm) with an aortocaval fistula (ACF), as evidenced by a jet effect of aortic blood flow into the inferior vena cava (IVC). An urgent surgery intervention was mandatory. Promptly, an abdominal preoperative computed tomography (CT scan) with contrast-enhanced arterial phase was performed as requested by the surgeon, and it confirmed the presence of the infrarenal abdominal aortic aneurysm (7 cm 9 9 cm of length). During the arterial phase, there was a rapid contrast filling of the inferior vena cava and iliac veins, indicating the presence of a large ACF confirming our hypothesis (Fig. 1). A subsequent three-dimensional CT scan reconstruction in coronary projection has identified a fistula between the aorta and the inferior vena cava just a few centimeters above the iliac vein (Fig. 2).Due to the considerable size of the ACF and the potentially unstable clinical situation, the patient was taken Fig. 1 CT scan: three of the four typical CT findings of ACF on CT are present in this slice. Early contrast enhancement of the inferior vena cava, which has the same density of the adjacent aorta, an associated aortic aneurysm, and loss of normal anatomic space between aorta and inferior vena cava (arrow). Contrast computed tomography simultaneously showed an abdominal infrarenal aortic aneurysm (7 9 9 cm) with communication between the aorta (AO) and the inferior vena cava (IVC). On the right you can see the true and the false lumen of the aortic aneurism, and on the left the aortocaval fistula (arrow)

show abstract

Aorto-Caval Fistula - an Uncommon Complication of Infrarenal Aortic Aneurysms

Cited by 65 publications

References 5 publications

Aneurisma ilíaco associado a fístula arteriovenosa

Aneurisma ilíaco associado a fístula arteriovenosa

Aorto-caval fistula clinically presenting as left renal colic Findings of multislice computed tomography

Aortocaval fistula

Contact Info

Product

Resources

About