Asymptomatic Hypogastric Arteriovenous Fistula Detected 40 Years After Shotgun Injury

84-year-old male, with a history of firearm incident with accidental gunshot shooting, and multiple projectile injuries, 40 years prior. No advanced medical treatment was required at the time. A CT was recently performed for unrelated reasons, and the scout view shows multiple projectiles, a total of 50, scattered in the thoracoabdominopelvic region as well as the lower limbs. CT angiography exposed CT's scout view of the multiple projectiles scattered. an arteriovenous fistula in posterior branches of the hypogastric artery with moderate dilations of the superior gluteal vein. The patient was completely asymptomatic and had no findings suggestive of AVF-related cardiac failure. Physical examination was unremarkable. Conservative treatment without further imagiological follow-up was decided, if patient continued asymptomatic.