Iliac arteriovenous fistula with renal insufficiency, ascites, hepatomegaly, and abnormal liver test results.
Arteriovenous fistula presents rarely with liver involvement. A 73-year-old man had new-onset ascites, hepatomegaly, and abnormal liver and renal function test results. An abdominal computed tomogram revealed a 7.6-cm internal iliac aneurysm but no other abnormality to account for his ascites. An aortogram demonstrated a 1.5-cm internal iliac arteriovenous fistula that subsequently was repaired, leading to resolution of his symptoms and laboratory abnormalities. High-output cardiac failure should be considered in the differential diagnosis of patients with new-onset massive ascites, hepatomegaly, and liver test abnormalities.
Chiorean
M V
MV
Division of General Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Morford
R G
RG
Bivins
M H
MH
Pardi
D S
DS
D000368:Aged; D001027:Aortography; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D001201:Ascites / Q000209:etiology*; D006529:Hepatomegaly / Q000097:blood / Q000209:etiology*; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D007083:Iliac Artery / Q000002:abnormalities*; D008111:Liver Function Tests; D008297:Male; D051437:Renal Insufficiency / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000002:abnormalities*