Beton Osman, Kaplanoğlu Hatice, Berkan Öcal, Yılmaz Mehmet Birhan
Department of Cardiology, Cumhuriyet University, Sivas, Turkey.
Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
J Clin Imaging Sci. 2015 Nov 30;5:62. doi: 10.4103/2156-7514.170731. eCollection 2015.
Chronic aortocaval fistula (ACP) is a rare complication of penetrating trauma to the abdomen. We report a case of traumatic ACP presenting with pulmonary hypertension and right heart failure symptoms 15 years after the initial penetrating injury. Although symptoms of pulmonary hypertension started 5 years ago, it was wrongly diagnosed and treated as chronic obstructive pulmonary disease. The presence of a continuous abdominal bruit and history of penetrating abdominal trauma gave rise to suspicion of a fistula, which was confirmed by computed tomography and angiography. Percutaneous closure of ACP was planned, but the patient died of severe pneumonia. The clinical presentation of chronic ACP can vary from being asymptomatic to symptoms related to pulmonary hypertension, right heart failure, and pulmonary embolism; thus, definitive diagnosis can be challenging.
慢性主动脉腔静脉瘘（ACP）是腹部穿透伤的一种罕见并发症。我们报告一例创伤性ACP病例，患者在初次穿透伤15年后出现肺动脉高压和右心衰竭症状。尽管肺动脉高压症状始于5年前，但被误诊并当作慢性阻塞性肺疾病进行治疗。持续性腹部杂音的存在以及腹部穿透伤病史引发了对瘘管的怀疑，这通过计算机断层扫描和血管造影得以证实。计划对ACP进行经皮闭合，但患者死于重症肺炎。慢性ACP的临床表现从无症状到与肺动脉高压、右心衰竭和肺栓塞相关的症状不等；因此，明确诊断可能具有挑战性。
