Imminent rupture of abdominal aortic aneurysm complicated by arteriovenous fistulaization and hepatorenal failure: case report and literature review

Reviews in Cardiovascular Medicine  2020, Vol. 21 Issue (1): 119-122     DOI: 10.31083/j.rcm.2020.01.588 Imminent rupture of abdominal aortic aneurysm complicated by arteriovenous fistulaization and hepatorenal failure: case report and literature review Daozheng Huang1, †, Feier Song2, †, Xiaomin Zhou3, Huan Ma3, Shuo Chen4, Yinjun Xie1, Shouhong Wang1, *(), Tiehe Qin1, *() 1 Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, P. R. China
2 Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China
3 Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China
4 Department of Echocardiography, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China Abstract:

Arteriovenous fistula (AVF) is a rare complication of the abdominal aortic aneurysm (AAA) with complex clinical features. However, AVF and AAA usually cause no symptoms except when they rupture. This case study demonstrated that ultrasonography was a rapid and non-invasive method for the initial assessment of AAA and AVF. A 65-year-old man was admitted to the intensive care unit with hepatic and renal dysfunction. Physical examination revealed an abdominal vascular murmur and bilateral toe discoloration. Ultrasonic examination revealed an AAA and right common iliac artery aneurysm with an AVF located between the right common iliac artery and inferior vena cava. A computed tomography scan confirmed the sonographic findings. We propose that ultrasound should be used more commonly as part of the initial evaluation of the potential and established vascular diseases.

Submitted:  11 November 2019      Accepted:  14 February 2020      Published:  30 March 2020      Fund: 
2012-649/National Clinical Key Specialty Construction Project of China
2013-544/National Clinical Key Specialty Construction Project of China
A2018064/Medical Scientific Research Foundation of Guangdong Province, Guangdong, People’s Republic of China *Corresponding Author(s):  huang1huang2@163.com (Shouhong Wang) and qintiehe@163.com (Tiehe Qin)    Service E-mail this article Add to citation manager E-mail Alert RSS Articles by authors Daozheng Huang    Feier Song    Xiaomin Zhou    Huan Ma    Shuo Chen    Yinjun Xie    Shouhong Wang    Tiehe Qin   

Figure 1.  Ultrasound images and CT of an AAA and AVF located between right common iliac artery aneurysm and IVC. Imaging was captured within one hour of admission. Figure 1A was sonograms showing an AAA and AVF between right common iliac artery aneurysm and IVC. AVF (thick arrows) between right common iliac artery aneurysm and IVC is clearly visible. Figure 1B and 1C were axial images from enhanced CT scans. Continuity between the right common iliac artery aneurysm and IVC represents AVF (thin arrow). Figure 1D and 1E were three-dimensional volume-rendered images of the AAA and AVF (red arrows). The figure here is original for this paper.


[1] Ali, M. U.,Fitzpatrick-Lewis, D.,Miller, J.,Warren, R.,Kenny, M.,Sherifali, D. and Raina, P. (2016)Screening for Abdominal Aortic Aneurysm in Asymptomatic Adults.Journal of Vascular Surgery 64, 1855-1868. [2] Armon, M.,Wenham, P.,Whitaker, S.,Gregson, R. and Hopkinson, B. (1998)Common Iliac Artery Aneurysms in Patients with Abdominal Aortic Aneurysms.European Journal of Vascular and Endovascular Surgery 15, 255-257. [3] Bode, P.,Edwards, M.,Kruit, M. and Van Vugt, A. (1999)Sonography in a Clinical Algorithm for Early Evaluation of 1671 Patients with Blunt Abdominal Trauma.AJR American Journal of Roentgenology 172, 905-911. [4] Catalano, O.,Lobianco, R.,Cusati, B. and Siani, A. (2005)Contrast-Enhanced Sonography for Diagnosis of Ruptured Abdominal Aortic Aneurysm.American Journal of Roentgenology 184, 423-427. [5] Chun, K. C.,Anderson, R. C.,Smothers, H. C.,Sood, K.,Irwin, Z. T.,Wilson, M. D. and Lee, E. S. (2019)Risk of Developing an Abdominal Aortic Aneurysm after Ectatic Aorta Detection from Initial Screening.Journal of Vascular Surgery [6] Coulier, B.,Tilquin, O. and Etienne, P.-Y.. (2004)Multidetector Row Ct Diagnosis of Aortocaval Fistula Complicating Aortic Aneurysm: A Case Report.Emergency Radiology 11, 100-103. [7] Goergen, C. J.,Johnson, B. L.,Greve, J. M.,Taylor, C. A. and Zarins, C. K. (2007)Increased Anterior Abdominal Aortic Wall Motion: Possible Role in Aneurysm Pathogenesis and Design of Endovascular Devices.Journal of Endovascular Therapy 14, 574-584. [8] Gregoric, I. D.,Jacobs, M. J.,Reul, G. J. and Rochelle, D. G. (1991)Spontaneous Common Iliac Arteriovenous Fistula Manifested by Acute Renal Failure: A Case Report.Journal of Vascular Surgery 14, 92-97. [9] Jones, P. G.,Peak, S.,McClelland, A.,Holden, A.,Higginson, I. and Gamble, G. (2003)Emergency Ultrasound Credentialling for Focused Assessment Sonography in Trauma and Abdominal Aortic Aneurysm: A Practical Approach for Australasia.Emergency Medicine 15, 54-62. [10] Lau, L. L.,O'Reilly, M. J.,Johnston, L. C. and Lee, B. (2001)Endovascular Stent-Graft Repair of Primary Aortocaval Fistula with an Abdominal Aortoiliac Aneurysm.Journal of Vascular Surgery 33, 425-428. [11] Lowe, C.,Ghulam, Q.,Bredahl, K.,Rogers, S.,Ghosh, J.,Sillesen, H.,McCollum, C. and Eiberg, J. (2016)Three-Dimensional Ultrasound in the Management of Abdominal Aortic Aneurysms: A Topical Review.European Journal of Vascular and Endovascular Surgery 52, 466-474. [12] Manning, B. J.,Kristmundsson, T.,Sonesson, B. and Resch, T. (2009)Abdominal Aortic Aneurysm Diameter: A Comparison of Ultrasound Measurements with Those from Standard and Three-Dimensional Computed Tomography Reconstruction.Journal of Vascular Surgery 50, 263-268. [13] Miller, J.,Grimes, P. and Miller, J. (1999)Case Report of an Intraperitoneal Ruptured Abdominal Aortic Aneurysm Diagnosed with Bedside Ultrasonography.Academic Emergency Medicine 6, 661-664. [14] Owen, B.,Lowe, C.,Ashton, N.,Mandal, P.,Rogers, S.,Wein, W.,McCollum, C. and Revell, A. (2016)Computational Hemodynamics of Abdominal Aortic Aneurysms: Three-Dimensional Ultrasound Versus Computed Tomography.Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 230, 201-210. [15] Rogers, S.,Lowe, C.,Carreira, J.,McCollum, C. and Ghosh, J. (2019)Comparison of Contrast-Enhanced Tomographic 3-D Ultrasound against Rotational Angiography Imaging Immediately after Endovascular Aneurysm Repair.Ultrasound in Medicine & Biology 45, 2356-2362. [16] Rosenthal, D.,Atkins, C. P.,Jerrius, H. S.,Clark, M. D. and Matsuura, J. H. (1998)Diagnosis of Aortocaval Fistula by Computed Tomography.Annals of Vascular Surgery 12, 86-87. [17] Scaife, M.,Giannakopoulos, T.,Al-Khoury, G. E.,Chaer, R. A. and Avgerinos, E. D. (2016)Contemporary Applications of Ultrasound in Abdominal Aortic Aneurysm Management.Frontiers in Surgery 3, 29. [18] Sidloff, D.,Stather, P.,Dattani, N.,Bown, M.,Thompson, J.,Sayers, R. and Choke, E. (2014)Aneurysm Global Epidemiology Study: Public Health Measures Can Further Reduce Abdominal Aortic Aneurysm Mortality.Circulation 129, 747-753. [19] Simsek, E.,Caliskan, A.,Tutun, U. and Sahin, S. (2014)Cause of a Rare Acute Renal Insufficiency: Rupture Aortocaval Fistula.Vascular 22, 290-292. [20] van Disseldorp, E. M.,van Dronkelaar, J. J.,Pluim, J. P.,van de Vosse, F. N.,van Sambeek, M. R. and Lopata, R. G. (2020)Ultrasound Based Wall Stress Analysis of Abdominal Aortic Aneurysms Using Multiperspective Imaging.European Journal of Vascular and Endovascular Surgery 59, 81-91. [21] Wilmink, A. and Quick, C. G. (1998)Epidemiology and Potential for Prevention of Abdominal Aortic Aneurysm.British Journal of Surgery 85, 155-162. No Suggested Reading articles found! Viewed Full text


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