Aortocaval fistula: CT appearance with angiographic correlation
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Computed tomography (CT) can detect rare complications of abdominal aortic aneurysms, such as aortocaval fistulas. Recognizing specific CT findings aids in diagnosing this condition and guiding further imaging.
Area of Science:
- Radiology
- Vascular Surgery
- Abdominal Imaging
Background:
- Computed tomography (CT) is the primary imaging modality for suspected abdominal aortic aneurysm (AAA) complications.
- Less common AAA complications require awareness for accurate diagnosis via CT.
Observation:
- A case of aortocaval fistula with resultant renal venous hypertension is presented.
- Specific CT imaging findings suggestive of this rare complication are detailed.
Findings:
- Key CT indicators include early, equal enhancement of the inferior vena cava and aorta.
- Other findings are enlarged, poorly functioning kidneys and perirenal "cobwebs" (edema).
Implications:
- Awareness of these CT findings facilitates prompt diagnosis of aortocaval fistulas.
- This recognition enables appropriate confirmatory angiographic studies for effective management.
Abstract:
As CT is often the initial imaging method in the evaluation of suspected complications of abdominal aortic aneurysm, especially rupture of the aneurysm, it is important to be aware of other less common complications that can be detected by CT. A patient with an aortocaval fistula and renal venous hypertension is discussed. The constellation of CT findings that suggest this diagnosis is described as is the angiographic correlation. Awareness of these CT findings, including early equivalent enhancement of the inferior vena cava and aorta; enlarged, poorly functioning kidney; and perirenal "cobwebs," will lead to the appropriate confirmatory angiographic studies.