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Open Access Case report

Aorto-venous fistula between an abdominal aortic aneurysm and an aberrant renal vein: a case report

Mélanie Faucherre1*, Nader Haftgoli-Bakhtiari1, Markus Menth3, Julien Gaude4 and Beat Lehmann2

Author Affiliations

1 Department of Internal Medicine, Cantonal Hospital, Fribourg, 1700, Switzerland

2 Emergency Department, Cantonal Hospital, Fribourg, 1700, Switzerland

3 Department of Surgery, Cantonal Hospital, Fribourg, 1700, Switzerland

4 Department of Radiology, Cantonal Hospital, Fribourg, 1700, Switzerland

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Journal of Medical Case Reports 2010, 4:255  doi:10.1186/1752-1947-4-255

Published: 8 August 2010

Abstract

Introduction

The potential complications of an abdominal aortic aneurysm include rupture, compression of surrounding structures, thrombo-embolic events and fistula. The most common site of arterio-venous fistula is the inferior vena cava. Fistula involving a renal vein is particularly uncommon.

Case presentation

This report describes a 54-year-old Caucasian woman who was admitted to the emergency department with fatigue, severe dyspnea and bilateral lower limb edema. In the first instance this anamnesis suggested possible heart failure. In fact, our patient presented with multi-organ system failure due to a fistula between an infra-renal aortic aneurysm and an aberrant retro-aortic renal vein.

Conclusions

To our knowledge, this is the first report of a woman with a fistula between an infra-renal aortic aneurysm and an aberrant retro-aortic left renal vein. Aorto-venous fistulas may be asymptomatic or may present with symptoms characteristic of arterio-venous shunting and/or aneurysm rupture. This type of fistula is a rare cause of heart failure. Clinical examination and imaging are essential for detection.