Aortocaval fistula

Revision as of 10:44, 8 September 2016 by Rossdonaldson1 (talk | contribs) (Differential Diagnosis)


  • 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

Diffuse Abdominal pain


  • US to identify AAA
  • CT angio


  • Treat hypovolemia/shock
  • Emergent surgical repair


  • Admit

See Also

External Links