A Case of Aortocaval Fistula due to Ruptured Abdominal Aortic Aneurysm

Abstract

A 65-year-old man who suffered from dyspnea with sudden onset was referred to our hospital by an ambulance. Pulmonary thromboembolism was suspected from his symptoms, echocardiographic findings and high FDP and D-dimer levels. However, enhanced CT scan revealed aortocaval fistula (ACF) due to ruptured abdominal aortic aneurysm, and pulmonary thromboembolism was denied. Emergent operation was performed successfully. It might be very important to distinguish ACF from pulmonary thromboembolism in the early phase of diagnosis because of its similarity of symptoms and laboratory findings due to high pulmonary pressure. Precise diagnosis is mandatory to rescue patients with ACF.