Spontaneous common iliac arteriovenous fistula manifested by acute renal failure: A case report

Abstract

Arteriovenous fistulas between the common iliac vessels resulting from spontaneous rupture of aneurysms are rare, with only 31 cases having been reported since 1971. Clinical diagnosis is possible when a unique set of findings is present, namely high-output cardiac failure, a pulsatile abdominal mass associated with a bruit or thrill, and unilateral arterial insufficiency or venous engorgement. Recently, with advancements in diagnostic techniques, the number of cases in which an arteriovenous fistula is found between the common iliac vessels has increased. Diagnosis can be difficult, however, as in the case of one of our patients in whom the predominant sign was acute renal failure. Other reports of renal failure or impairment in the presence of a common iliac fistula have also appeared. Awareness of this phenomenon can help the physician to establish the diagnosis when one or more of the classic signs are absent. Prompt diagnosis and surgical management have contributed to the high incidence of survival in patients with arteriovenous fistulas between the common iliac vessels.

Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

“…Sometimes, the patient can present with congestive cardiac failure, leg edema and leg ischemia [5]. Gregoric et al [6] first described a case of an aortocaval fistula presenting as acute renal failure. Since then, there have been only three cases [7-9] where the patient has presented with multiorgan failure.…”

Mycotic aneurysm leading to iliac arteriovenous fistula diagnosed by vascular duplex color scan.

“…In 84% of cases, they are caused by gunshot wounds, stab wounds, seat belt trauma, 4 and iatrogenic injury; spontaneous rupture of aneurysms occurs in the remaining 16%. 5,6 These iliac arterial aneurysms are atherosclerotic or associated with infection, such as tuberculosis, syphilis, or mycotic aneurysm. 6,7 In 1831, Syme was the first to report an aortocaval fistula in a 22 year old man with syphilitic aortitis and aneurysm.…”

“…5,6 These iliac arterial aneurysms are atherosclerotic or associated with infection, such as tuberculosis, syphilis, or mycotic aneurysm. 6,7 In 1831, Syme was the first to report an aortocaval fistula in a 22 year old man with syphilitic aortitis and aneurysm. 8 …”

“…9-11 Gregoric and colleagues reviewed 32 reported cases of common iliac AVF, all resulting from the erosion of an arteriosclerotic common iliac artery aneurysm into an adjacent common iliac vein. 6 McAuley and associates reviewed 13 published cases of spontaneous AVF. They suggested a unique syndrome with the following clinical findings: (1) fulminant onset of high-output failure, (2) a pulsatile lower abdominal mass with an associated bruit and thrill, and (3) acute onset of unilateral lower extremity arterial insufficiency or venous engorgement.…”

Iliac Arteriovenous Fistula Secondary To Iliac Aneurysm Rupture: Multidetector Computed Tomographic Angiography Findinds İliyak Anevrizma Rüptürüne Sekonder Gelişen İliyak Arteriyovenöz Fistül: Multid

“…In addition, one third of the patients have contralateral iliac aneurysms (2). Spontaneous rupture of iliac arterial aneurysm into the iliac venous system is less common (3). Iliac arteriovenuos fistula is a life-threatening condition that requires immediate diagnosis and treatment.…”