Spencer Todd A, Smyth Stephen H, Wittich Gerard, Hunter Glenn C
Department of Surgery, The University of Texas Medical Branch, Galveston 77555-0541, USA.
J Vasc Surg. 2006 Apr;43(4):836-40. doi: 10.1016/j.jvs.2005.12.003.
Chronic aortocaval fistula (ACF) is a rare complication of gunshot wounds to the abdomen. Herein we report two cases of traumatic ACF: one asymptomatic and the other presenting with congestive heart failure (CHF) 20 and 30 years, respectively, after their initial injury. The recent onset of CHF, the presence of a continuous abdominal bruit, and, in the second patient, a history of penetrating trauma suggested the diagnosis of ACF. The diagnosis was confirmed by computed tomography scanning in both patients. Surgical repair of the ACF in the symptomatic patient resulted in resolution of the CHF and reversed the dilatation of the aorta and inferior vena cava. The asymptomatic patient was lost to follow-up. CHF in a young male patient with a history of penetrating abdominal trauma should alert the surgeon to this rare complication.
慢性主动脉腔静脉瘘（ACF）是腹部枪伤的一种罕见并发症。在此，我们报告两例创伤性ACF病例：一例无症状，另一例在初次受伤后分别于20年和30年出现充血性心力衰竭（CHF）。近期发生的CHF、持续性腹部血管杂音的存在，以及第二例患者的穿透性创伤史提示了ACF的诊断。两名患者均经计算机断层扫描确诊。对有症状患者的ACF进行手术修复后，CHF得到缓解，主动脉和下腔静脉的扩张也得到逆转。无症状患者失访。有穿透性腹部创伤史的年轻男性患者出现CHF应提醒外科医生注意这种罕见并发症。
