Aortocaval fistula

Revision as of 23:17, 4 September 2016 by ClaireLewis (talk | contribs)

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