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Aortocaval fistula: CT appearance with pathological correlation
S Roggen1, D Fonck, P Seynaeve
1Department of Radiology, Middelheim Hospital, Antwerp, Belgium.
Insights
A rare complication of atherosclerotic abdominal aortic aneurysm, aortocaval fistulization, was diagnosed using contrast-enhanced computed tomography. Surgical attempts were unsuccessful, highlighting the diagnostic and management challenges of this condition.
Area of Science:
- Vascular Surgery
- Radiology
- Gastroenterology
Background:
- Abdominal aortic aneurysms (AAAs) are common, with known complications like rupture and thrombosis.
- Aortocaval fistulization is an exceptionally rare but serious complication of AAAs.
Observation:
- A patient presented with an abdominal aortic aneurysm.
- The patient developed an aortocaval fistula, a direct connection between the aorta and the inferior vena cava.
Findings:
- Contrast-enhanced computed tomography (CECT) accurately diagnosed the aortocaval fistula.
- Surgical intervention was attempted but ultimately unsuccessful, indicating the complexity of managing this condition.
Implications:
- This case underscores the importance of considering rare complications in AAA management.
- Advanced imaging like CECT is crucial for diagnosing aortocaval fistulas.
- The findings suggest potential challenges in surgical repair and the need for further investigation into optimal treatment strategies.
Abstract:
Atherosclerotic aneurysm of the abdominal aorta is a frequent finding in a general hospital patient population. Most complications such as rupture, thrombosis and superinfection are well known. We report on a patient with aortocaval fistulization. This rare complication was diagnosed on contrast enhanced computed tomography. Pathological correlation was obtained as attempted surgery was unsuccessful.