PMC4683789_01
50-year-old male presented with edema of legs, erythema, pain, and abdominal swelling and was later diagnosed with chronic aortocaval fistula. Abdominal photograph of patient shows a continuous thrill (star), and a machine-like murmur was detected on the umbilical region of the abdomen.
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F1
On the umbilical region of the abdomen, a continuous thrill and a machine-like murmur were detected [Figure 1].
50-year-old male presented with edema of legs, erythema, pain, and abdominal swelling and was later diagnosed with chronic aortocaval fistula. Transesophageal echocardiography (a) on transverse plane, (b) on the region of abdominal murmur, show fistula between the abdominal aorta and the IVC.
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F2
On the region of abdominal murmur, the echo probe showed fistula between the abdominal aorta and the IVC on transverse plane [Figure 2a and b].
50-year-old male presented with edema of legs, erythema, pain, and abdominal swelling and was later diagnosed with chronic aortocaval fistula. Axial contrast-enhanced CT angiography, (120/350 cc contrast medium, injection rate 4 cc/sec, scan time 30. sec) shows fistula (black arrow) at the lower level of renal artery and the bifurcation of the aorta between the abdominal aorta (yellow arrow) and the IVC. (b) Axial contrast-enhanced CT angiography, showed fistula (black arrow) at the at the abdominal aortic bifurcation, between the abdominal aorta (yellow arrow) and the IVC.
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F3
At the localization of fistula on the lower level of the renal artery [Figure 3a], the diameter of the aorta was 22 mm, IVC diameter was 99 mm, and the diameter of the fistula tract was 11 mm. At the localization of fistula on the abdominal aortic bifurcation [Figure 3b], the aortic diameter was 25 mm, IVC diameter was 169 mm, and fistula tract diameter was 17 mm.
50-year-old male presented with edema of legs, erythema, pain, and abdominal swelling and was later diagnosed with chronic aortocaval fistula. Abdominal aortography shows two fistulas (stars) between the abdominal aorta and the IVC.
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F4
On abdominal aortography, findings consistent with CT angiography (two fistulas from the abdominal aorta to the IVC) were found [Figure 4].
50-year-old male presented with edema of legs, erythema, pain, and abdominal swelling later diagnosed with chronic aortocaval fistula. Coronary arteries are seen on coronary angiography.
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F5
On coronary angiography, the coronary arteries were normal and systolic pulmonary artery pressure was 75 mmHg [Figure 5].