Difference between revisions of "Aortocaval fistula"

(Clinical Features)
Line 7: Line 7:
 
*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)
 
*Signs/symptoms of [[AAA]] (abdominal/flank/back pain, shock if ruptured)
*High output cardiac failure
+
*[[High-output heart failure]]
*Pedal edema (due to venous hypertension)
+
*[[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
  

Revision as of 19:22, 5 September 2016

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

  • Presentation depends on origin, size, and location of fistula
  • Signs/symptoms of AAA (abdominal/flank/back pain, shock if ruptured)
  • High-output heart 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

External Links

References