We present a case of aortocaval fistula (ACF) secondary to spontaneous
rupture of an atherosclerotic infrarenal aortic aneurysm into the inf
erior vena cava that was initially diagnosed with computed tomography
(CT). This is believed to be the first report of this condition with C
T demonstration of the exact site of fistula and CT-pathologic correla
tion. We retrospectively reviewed the CT findings of another two cases
of ACF and the previous literature.