Reviews in Cardiovascular Medicine  2020, Vol. 21 Issue (1): 119-122     DOI: 10.31083/j.rcm.2020.01.588 Imminent rupture of abdominal aortic aneurysm complicated by arteriovenous fistulaization and hepatorenal failure: case report and literature review Daozheng Huang1, †, Feier Song2, †, Xiaomin Zhou3, Huan Ma3, Shuo Chen4, Yinjun Xie1, Shouhong Wang1, *(), Tiehe Qin1, *() 1 Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, P. R. China
2 Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China
3 Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China
4 Department of Echocardiography, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China Abstract:

Arteriovenous fistula (AVF) is a rare complication of the abdominal aortic aneurysm (AAA) with complex clinical features. However, AVF and AAA usually cause no symptoms except when they rupture. This case study demonstrated that ultrasonography was a rapid and non-invasive method for the initial assessment of AAA and AVF. A 65-year-old man was admitted to the intensive care unit with hepatic and renal dysfunction. Physical examination revealed an abdominal vascular murmur and bilateral toe discoloration. Ultrasonic examination revealed an AAA and right common iliac artery aneurysm with an AVF located between the right common iliac artery and inferior vena cava. A computed tomography scan confirmed the sonographic findings. We propose that ultrasound should be used more commonly as part of the initial evaluation of the potential and established vascular diseases.

Submitted:  11 November 2019      Accepted:  14 February 2020      Published:  30 March 2020      Fund: 
2012-649/National Clinical Key Specialty Construction Project of China
2013-544/National Clinical Key Specialty Construction Project of China
A2018064/Medical Scientific Research Foundation of Guangdong Province, Guangdong, People’s Republic of China *Corresponding Author(s):  huang1huang2@163.com (Shouhong Wang) and qintiehe@163.com (Tiehe Qin)    Service E-mail this article Add to citation manager E-mail Alert RSS Articles by authors Daozheng Huang    Feier Song    Xiaomin Zhou    Huan Ma    Shuo Chen    Yinjun Xie    Shouhong Wang    Tiehe Qin   

Figure 1.  Ultrasound images and CT of an AAA and AVF located between right common iliac artery aneurysm and IVC. Imaging was captured within one hour of admission. Figure 1A was sonograms showing an AAA and AVF between right common iliac artery aneurysm and IVC. AVF (thick arrows) between right common iliac artery aneurysm and IVC is clearly visible. Figure 1B and 1C were axial images from enhanced CT scans. Continuity between the right common iliac artery aneurysm and IVC represents AVF (thin arrow). Figure 1D and 1E were three-dimensional volume-rendered images of the AAA and AVF (red arrows). The figure here is original for this paper.

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