title: Aorta-left renal vein fistula complicating an aortic aneurysm: preoperative and postoperative multislice CT findings.
abstract: Fistulas complicating an abdominal aortic aneurysm (AAA) are rare, and fistulas involving the left renal vein are particularly uncommon. We highlight here a fistula between an infrarenal aortic aneurysm and a retroaortic left renal vein, revealed by left flank pain associated with hematuria and acute renal failure. The multislice CT angiography performed in this 68-year-old patient revealed communication and equal enhancement between the aorta and the left gonadic vein, suggesting the presence of a fistula. The three-dimensional VRT reconstructions presented in this case were of great value in the preoperative planning, enabling immediate visualization of this unusual feature. Alternative diagnoses to consider when encountering this clinical presentation are reviewed.
authors.affiliation: Department of Radiology, Hopital de Rangueil CHU de Toulouse, 1 avenue Jean Poulhes TSA 50032, 31059 Toulouse Cedex, France. p.barrier@gmail.com
authors.forename: Pierre
authors.initials: P
authors.lastname: Barrier
authors.forename: Philippe
authors.initials: P
authors.lastname: Otal
authors.forename: Olivier
authors.initials: O
authors.lastname: Garcia
authors.forename: Olivier
authors.initials: O
authors.lastname: Vahdat
authors.forename: Brice
authors.initials: B
authors.lastname: Domenech
authors.forename: Valérie
authors.initials: V
authors.lastname: Lannareix
authors.forename: Francis
authors.initials: F
authors.lastname: Joffre
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000601:surgery; D001027:Aortography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D003097:Collateral Circulation / Q000502:physiology; D005500:Follow-Up Studies; D005837:Genitalia, Male / Q000098:blood supply*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007668:Kidney / Q000098:blood supply; D007677:Kidney Function Tests; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed; D014646:Varicocele / Q000000981:diagnostic imaging* / Q000601:surgery