Spontaneous aortocaval fistula presenting with acute liver and renal failure: a case report

Spontaneous aortocaval fistula is rare, occurring only in 3%-6% of all ruptured abdominal aortic aneurysms. A definitive diagnosis of aortocaval fistula is sometimes difficult, as the classic diagnostic signs (pulsatile abdominal mass with bruit, high-output heart failure and acute dyspnea) are present only in 20%-50% of all such cases. Pre-operative diagnosis is crucial, as adequate preparation has to be made for the massive bleeding expected at operation. Surgical repair of aortocaval fistula is now standardized repair of the fistula. We report herein a case of spontaneous aortocaval fistula, which presented with liver and renal failure.