title: Surgical repair of a concealed aortocaval fistula associated with an abdominal aortic aneurysm: report of two cases.
abstract: Two cases of a concealed aortocaval fistula (ACF) associated with an abdominal aortic aneurysm (AAA) are presented herein. ACF is a rare complication of AAA and only a few cases have so far shown the triad of symptoms, including congestive heart failure, a continuous abdominal bruit, and a pulsating abdominal mass. Sometimes a definite diagnosis is not made preoperatively and as a result, massive bleeding is encountered. We believe that the presence of a large aneurysm, compression, and involvement of the inferior vena by an aneurysm, and pelvic venous dilatation on abdominal computed tomography and hematuria may additionally suggest the presence of a concealed ACF. A correct preoperative diagnosis will help greatly in selecting the optimal surgical modality and should also reduce the degree of bleeding.
authors.affiliation: Department of Cardiovascular Surgery, Ageo Central General Hospital, Saitama, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Takazawa
authors.forename: H
authors.initials: H
authors.lastname: Sakahashi
authors.forename: A
authors.initials: A
authors.lastname: Toyama
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications* / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000150:complications* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior