Aortocaval fistula: Difference between revisions

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==Background==
==Background==
*Complication of [[abdominal aortic aneurysm]]
*Rare (<1% of all AAAs, ~3% of ruptured AAAs) but life-threatening (mortality ~50%)
*Inflammation around aorta--> adherence of aorta to vein --> pressure and erosion into vein--> fistula


==Clinical Features==
==Clinical Features==
*Presentation depends on origin, size, and location of fistula
*Signs/symptoms of [[AAA]] (abdominal/flank/back pain, shock if ruptured)
*High output cardiac failure
*Pedal edema (due to venous hypertension)
*Renal insufficiency (due to reduced perfusion to kidneys)
*Hematuria
*Bruit


==Differential Diagnosis==
==Differential Diagnosis==


==Evaluation==
==Evaluation==
*US to identify AAA
*CT angio


==Management==
==Management==
*Treat hypovolemia/shock
*Emergent surgical repair


==Disposition==
==Disposition==
*Admit


==See Also==
==See Also==
*[[AAA]


==External Links==
==External Links==

Revision as of 23:17, 4 September 2016

Background

  • Complication of abdominal aortic aneurysm
  • Rare (<1% of all AAAs, ~3% of ruptured AAAs) but life-threatening (mortality ~50%)
  • Inflammation around aorta--> adherence of aorta to vein --> pressure and erosion into vein--> fistula

Clinical Features

  • Presentation depends on origin, size, and location of fistula
  • Signs/symptoms of AAA (abdominal/flank/back pain, shock if ruptured)
  • High output cardiac failure
  • Pedal edema (due to venous hypertension)
  • Renal insufficiency (due to reduced perfusion to kidneys)
  • Hematuria
  • Bruit

Differential Diagnosis

Evaluation

  • US to identify AAA
  • CT angio

Management

  • Treat hypovolemia/shock
  • Emergent surgical repair

Disposition

  • Admit

See Also

  • [[AAA]

External Links

References