Aortocaval fistula due to ruptured abdominal aortic aneurysm

The rupture of an abdominal aortic aneurysm (AAA) is a devastating surgical condition associated with a very high morbidity and mortality. An aortocaval fistula (ACF) is an unusual, rare complication of ruptured AAA, involving less than 3–6% of all ruptured cases. The clinical manifestations are vague, depending on the degree of haemodynamic instability. A preoperative diagnosis can be made with thorough clinical assessment and timely imaging. This report tells us about the surgical treatment of a patient presented to the emergency department with an aortocaval fistula due to ruptured AAA. Furthermore, it will highlight the need for the high index of suspicion for early diagnosis and treatment of this often lethal condition.

The Sri Lanka Journal of Surgery 2014; 32(4): 24-27