Aortocaval fistula treated by aortic exclusion.

Aortocaval fistulas are a rare complication of spontaneous rupture of an abdominal aortic aneurysm, representing an incidence of 2% and 4%. A review of the literature revealed 159 reported cases of aortocaval fistulas. We recently had a patient admitted to our institution with an abdominal aortic aneurysm that ruptured into the vena cava. The presence of the fistula was only recognized during operation. Primary closure of the fistula was not possible, and the aneurysmal segment was excluded. To our knowledge, this is the first report of aortic exclusion being used as the surgical treatment of an aortocaval fistula.