SPONTANEOUS RUPTURE OF AN ABDOMINAL AORTIC ANEURYSM INTO THE INFERIOR VENA CAVA

Abstract

Although sporadic reports of arteriovenous fistulas between the aorta and inferior vena cava have been noted in the literature, these were the results of trauma, usually a gunshot wound. The spontaneous rupture of an abdominal aortic aneurysm into the inferior vena cava is a rare occurrence. Viar and Lombardo¹reported in 1952 what they believed to be the first case. Their patient survived about six weeks after the development of such a spontaneous fistula, manifesting signs of severe progressive right heart failure, unresponsive to all medical therapy. Autopsy revealed a 13-cm. aortic aneurysm with a 1-cm. opening into the inferior vena cava. More recently, Eiseman and Hughes²and Shumacker and Jontz³each described successful resection of an abdominal aortic aneurysm which had ruptured into the inferior vena cava and the replacement with a graft after closure of the caval defect. Both patients manifested severe cardiac failure, massive