Hospital: Hospital Universitario Vírgen del Rocío.
Nº: C2019-182
Aut@r o Autores: F. Galván, M. Parada, J. Jurado, P. Gómez-Millán, M. Espinosa De Los Monteros, F. Álvarez.
Presentación
We present the case of a 68-year-old man who came to the emergency with symptoms of abdominal pain and hematuria, with analytical deterioration of renal function. The abdominal ultrasound showed an abdominal aortic aneurysm (AAA) as an incidental finding. The TC-angiography revealed an arteriovenous (A-V) aorto-left renal vein fistula with simultaneous contrast filling of the aneurysm, the left renal artery and the left retroaortic renal vein. The left kidney was edematous with no contrast uptake. The aneurysm was urgently repaired by an aorto biiliac endoprosthesis replacement, sealing the fistula and improving renal function progressively.
Discusión
Ruptured AAA with fistulization to a nearby venous structure is an uncommon complication. The aorto-cava fistula is the most frequently described in the literature, being the aorto-renal fistula less known. The left retroaortic renal vein represents an anatomical variant that favors this complication.
Conclusión
Aorto-renal fistula from an AAA is a rare clinical condition associated with significant morbidity and mortality, so it is very important a high clinical suspicion, an early radiological diagnosis and an urgent surgical intervention in order to preserve renal function and also to save patient’s life.
Bibliografía
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