# Ruptured abdominal aortic aneurysm and aortocaval fistula: a highly lethal find

## TL;DR

This paper reports a rare and life-threatening case of a ruptured abdominal aortic aneurysm with an aortocaval fistula and highlights the challenges in treating this condition.

## Contribution

The paper presents a clinical case emphasizing the rarity and high risk of aortocaval fistulas due to ruptured aneurysms.

## Key findings

- Aortocaval fistula is a rare but highly lethal complication of abdominal aortic aneurysms.
- Emergency surgical intervention is critical for managing this condition, though it remains associated with high morbidity and mortality.
- Clinical manifestations vary depending on the progression of the disease.

## Abstract

Within the spectrum of abdominal aortic aneurysm, various complications can arise, including the development of an arteriovenous fistula connecting this major vessel to the infrarenal inferior vena cava. This report presents the case of a 70-year-old man with sudden, intense abdominal pain and syncope, found intraoperatively to have an aortocaval fistula due to a ruptured abdominal aortic aneurysm. The patient underwent emergency care, including fistula closure and placement of a Dacron aortobifemoral graft. Aortocaval fistula is a rare complication of aortic aneurysmal disease, with clinical manifestations varying depending on disease progression, leading to high morbidity and mortality both before and after surgical or interventional treatment.

Dentro del espectro de aneurisma de aorta abdominal, se presentan diversas complicaciones asociadas a esta patología, entre ellas el desarrollo de una fístula arteriovenosa que comunica este gran vaso con la vena cava inferior a nivel infrarrenal. En este reporte, se presenta el caso de un hombre de 70 años con dolor abdominal súbito intenso asociado a síncope, el cual tuvo un hallazgo intraoperatorio de fístula aortocava en el contexto de un aneurisma de aorta abdominal roto. El paciente fue manejado de forma emergente, realizándose el cierre de la fístula y la colocación de un injerto aortobifemoral de dacrón. La fístula aortocava es una complicación rara de la patología aneurismática aórtica, cuyas manifestaciones clínicas varían según el tiempo de evolución de la enfermedad, lo que conlleva una elevada morbimortalidad antes y después de su tratamiento quirúrgico y/o intervencionista.