Spontaneous iliac arteriovenous fistula

The formation of an iliac arteriovenous fistula caused by rupture of an atherosclerotic iliac artery aneurysm is unusual. We describe a case and review the previously reported 18 cases of spontaneous iliac arteriovenous fistula. The presence of a palpable abdominal mass associated with a thrill or bruit and unilateral leg symptoms of venous engorgement or arterial insufficiency, with or without acute onset of congestive heart failure, should result in a high index of suspicion of this entity. Prompt recognition and surgical closure of the iliac fistula are most important in successful management.