Difference between revisions of "Aortocaval fistula"

(Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ==Evaluation== ==Management== ==Disposition== ==See Also== ==External Links== ==References== <references/>")
 
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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