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Updated: Jul 28, 2026

Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Abdominal aortic aneurysms complicated by spontaneous iliocaval or duodenal fistulae
N C Hickey1, R Downing, J D Hamer
1Department of Vascular Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, England.
Abstract:
Seven hundred and twenty one abdominal aortic aneurysms were treated between 1960 and 1985. Twenty one of these (2.9%) were complicated by the development of a spontaneous primary fistula, 16 (2.2%) into the vena cava or iliac veins and 5 (0.7%) into the duodenum. A correct preoperative diagnosis was made in only four instances, two aorto-caval and two aorto-duodenal fistulae. Hospital mortality was 44% for aorto-caval and 60% for aorto-duodenal fistulae. Despite the lack of a precise preoperative diagnosis in the majority of cases, the prognosis for aorto-caval fistula remained comparable to that for patients undergoing emergency surgery for uncomplicated ruptured aortic aneurysms. The mortality of spontaneous aorto-duodenal fistulae was appreciably higher and the aneurysmal contents of 4 out of these 5 cases had positive bacterial cultures.
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