Abstract
Arteriovenous fistulas (AV fistulas) are uncommon, and are associated with severe complications such as abdominal aortic aneurysm and iliac artery aneurysm. Varying degrees of clinical symptoms are observed depending on the size of the fistula and the duration of the disease. We report a case of an 85-year-old woman with a right common iliac artery aneurysm complicated by an iliac AV fistula, presenting with left leg swelling and left leg pain caused by deep vein thrombosis (DVT), and suffering from acute renal failure. Abdominal early-enhanced computed tomography showed a right common iliac artery aneurysm and surrounding dilated iliac vein. An iliac AV fistula was definitively diagnosed by angiography. Emergency surgery was performed, and a right common iliac aneurysm, 5.5 cm in size and which was connected to the left common iliac vein, was resected and replaced with a prosthetic graft, in addition to closure of the AV fistula with the aneurysmal wall. The patient had an uncomplicated postoperative recovery, and her renal failure improved rapidly within a few days after the operation. Anti-coagulation therapy was performed 12 days after postoperatively for DVT of the left leg. The patient was discharged 52 days after surgery without any disability. We encountered an iliac artery aneurysm with an AV fistula, which caused DVT of the left leg and renal failure. Because of the varying degrees of its clinical symptoms, this disease should be kept in mind during the differential diagnosis of abdominal aortic aneurysm and iliac artery aneurysm, as it may otherwise fail to be detected, especially in the emergency phase.
