Difference between revisions of "Aortocaval fistula"

 
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*Complication of [[abdominal aortic aneurysm]]
 
*Complication of [[abdominal aortic aneurysm]]
 
*Rare (<1% of all AAAs, ~3% of ruptured AAAs) but life-threatening (mortality ~50%)
 
*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
+
*Caused by 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
 
*Presentation depends on origin, size, and location of fistula
*Signs/symptoms of [[AAA]] (abdominal/flank/back pain, shock if ruptured)
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*Signs/symptoms of [[AAA]] ([[abdominal pain|abdominal]]/[[flank pain|flank]]/[[back pain]], [[shock]] if ruptured)
*High output cardiac failure
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*[[High-output heart failure]]
*Pedal edema (due to venous hypertension)
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*[[Pedal edema]] (due to venous hypertension)
 
*Renal insufficiency (due to reduced perfusion to kidneys)
 
*Renal insufficiency (due to reduced perfusion to kidneys)
*Hematuria
+
*[[Hematuria]]
 
*Bruit
 
*Bruit
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 +
{{Abdominal Pain DDX Diffuse}}
  
 
==Evaluation==
 
==Evaluation==
*US to identify AAA
+
*[[Ultrasound: AAA|US]] to identify AAA
 
*CT angio
 
*CT angio
  
 
==Management==
 
==Management==
*Treat hypovolemia/shock  
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*Treat [[hypovolemia]]/[[shock]]
 
*Emergent surgical repair
 
*Emergent surgical repair
  
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==See Also==
 
==See Also==
*[[AAA]
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*[[Abdominal aortic aneurysm]]
  
 
==External Links==
 
==External Links==
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==References==
 
==References==
 
<references/>
 
<references/>
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 +
[[Category:Surgery]] [[Category:Vascular]]

Latest revision as of 16:20, 25 October 2019

Background

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

Clinical Features

Differential Diagnosis

Diffuse Abdominal pain

Evaluation

  • US to identify AAA
  • CT angio

Management

Disposition

  • Admit

See Also

External Links

References