Aortocaval fistula associated with ruptured abdominal aortic aneurysm.

Aortocaval fistula (ACF) is a well-known but uncommon complication of ruptured abdominal aortic aneurysm (AAA). Even with attentive care, oversight of ACFs may occur in emergency cases. Because mortality due to ACF is high, a rapid multidirectional analysis of the preoperative state leading to a correct diagnosis is essential. Here, we report the case of an 82-year-old man with a ruptured AAA and ACF. He presented with multiple organ failure that was initially attributed to congestive heart failure. He underwent emergent surgery and was diagnosed intraoperatively as having an AAA with ACF. He left the hospital 1 month after the operation without complications.