SPONTANEOUS AORTOCAVAL FISTULA

Rupture of an abdominal aortic aneurysm into the inferior vena cava is uncommon. A classic syndrome of high-ouput heart failure, continuous abdominal bruit, and renal insufficiency has been described and permit s a clinical diagnosis if an aortocaval fistula is considered in the d ifferential diagnosis. Classic signs and symptoms can be misinterprete d and are present in less than 50% of cases. Physicians should conside r abdominal ultrasonography and aortography in stable patients, follow ed by prompt surgical intervention. We report the case of a patient wi th an aortocaval fistula.