Brewster D C, Ottinger L W, Darling R C
Ann Surg. 1977 Dec;186(6):766-71. doi: 10.1097/00000658-197712000-00020.
An aorto-caval fistula is a rare complication of an abdominal aortic aneurysm (AAA). Typical features, including congestive heart failure and a loud abdominal bruit, may be present and allow prompt diagnosis, but not infrequently they are absent or overlooked and the diagnosis not made preoperatively. Four patients with an AAA and an aorto-caval fistula are described, each of whom presented with hematuria. We believe the presence of hematuria in a patient with a symptomatic AAA should suggest the diagnosis of an aorto-caval fistula. A correct preoperative diagnosis may contribute to better planning of the operative procedure, reduced blood loss, and avoidance of possible pulmonary embolization.
主动脉腔静脉瘘是腹主动脉瘤（AAA）的一种罕见并发症。其典型特征包括充血性心力衰竭和响亮的腹部杂音，可能存在并有助于迅速诊断，但这些特征常常缺失或被忽视，术前未能做出诊断。本文描述了4例患有腹主动脉瘤和主动脉腔静脉瘘的患者，他们均表现为血尿。我们认为，有症状的腹主动脉瘤患者出现血尿应提示主动脉腔静脉瘘的诊断。正确的术前诊断有助于更好地规划手术操作、减少失血并避免可能的肺栓塞。
