RUPTURED AORTIC PSEUDO-ANEURYSM - A RARE PRESENTATION AS AORTOCAVAL FISTULA

Pseudo-aneurysms after abdominal aortic replacement are rare, occurrin g in less than 1% of operated patients, Usually asymptomatic, they may present clinically as a pulsatile mass or less commonly complicated w ith rupture, Aortocaval fistulas are rare, usually related to ruptured aortic aneurysms or trauma. A case of aortocaval fistula secondary to a ruptured pseudoaneurysm in a 81 year old woman is reported. After a n infrarenal aortic aneurysm repair, the patient remained asymptomatic for 7 years, but abdominal pain and syncope developed and prompted fu rther investigation. She was found to have a 6 cm by 6 cm retroaortoca val false aneurysm which had ruptured into the inferior vena cava, Com puted tomography with intravenous contrast suggested the diagnosis and color Doppler ultrasound failed to confirm it. The etiology and manag ement of this rare case are discussed.