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[Traumatic aorto-caval fistula (author's transl)]
Zentralblatt Fur Chirurgie
|January 1, 1977
Summary
A traumatic aorto-caval fistula developed after a thoracoabdominal injury. Surgical obliteration and nephrectomy were successful, with alternative treatments suggested.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Nephrology
Background:
- A 33-year-old male presented with a thoracoabdominal bullet injury.
- Initial exploration revealed liver lacerations and gastric perforation.
Observation:
- Two months post-injury, the patient developed bilateral pleural effusion, hypertension, and heart failure.
- A continuous murmur was noted in the right hypochondrium.
- Aortography confirmed an aorto-caval fistula near the right renal artery and a non-functioning right kidney.
Findings:
- An aorto-caval fistula was successfully treated with external obliteration.
- A right nephrectomy was performed due to the non-functioning kidney and fistula complications.
- Heavy adhesions complicated the surgical approach.
Implications:
- This case highlights a rare complication of thoracoabdominal trauma.
- External fistula obliteration combined with nephrectomy is a viable treatment option.
- Profound hypothermia/circulatory arrest and aortic compressors/open fistulectomy were considered alternatives.