Spontaneous Arteriovenous Fistula Between the Abdominal Aorta and Vena Cava

Abstract

The spontaneous development of an arteriovenous fistula between the abdominal aorta and the inferior vena cava is unusual. In 1899 Boinet² cited 20 such cases. More recently, a number of cases with this abnormality have been reported.^3-7,9,11-13 To date there have been recorded three successfully treated cases of abdominal aortic aneurysms with rupture into the inferior vena cava.^4,5,12 One of these subsequently died six months postoperatively of a duodenal fistula incurred at the time of his aortic repair.⁵ Each of these three successful cases had undergone resection of the aneurysm, closure of the fistula into the inferior vena cava, and replacement of the terminal aorta with an aortic graft. Several unsuccessful surgical attempts to treat such lesions are also recorded.^3,6,7,9 Recently we have had the opportunity of treating a patient with a spontaneous aorticvena caval fistula. This case is presented, not only because of the