Hospital: Hospital Universitario Vírgen del Rocío.
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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:
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.
Bibliografía:
– Mellnick VM, Heiken JP. The Acute Abdominal Aorta. Radiol Clin N Am, 2015, 53: 1209-1224. – Sever A, Rheinboldt M. Unstable abdominal aortic aneurysms: a review of MDCT imaging features. Emerg Radiol, 2016, Published online. – Davidovic LB, Markovic M