Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202401343
Jornal Vascular Brasileiro
Therapeutic Challenge

Aneurisma roto de aorta abdominal y fístula aortocava: un hallazgo altamente letal

Ruptured abdominal aortic aneurysm and aortocaval fistula: a highly lethal find

Walter Mario Ángel Jaramillo; Marby Sharyne Forero Gaviria; Romario Chanci Drago; Natalia Guzmán Arango; Natalia Barrera Cuesta; Andrés Gilberto Giraldo Echeverri; Verónica Lucía Malabet Mejía

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Resumen

Dentro del espectro de aneurisma de aorta abdominal, se presentan diversas complicaciones asociadas a esta patología, entre ellas el desarrollo de una fístula arteriovenosa que comunica este gran vaso con la vena cava inferior a nivel infrarrenal. En este reporte, se presenta el caso de un hombre de 70 años con dolor abdominal súbito intenso asociado a síncope, el cual tuvo un hallazgo intraoperatorio de fístula aortocava en el contexto de un aneurisma de aorta abdominal roto. El paciente fue manejado de forma emergente, realizándose el cierre de la fístula y la colocación de un injerto aortobifemoral de dacrón. La fístula aortocava es una complicación rara de la patología aneurismática aórtica, cuyas manifestaciones clínicas varían según el tiempo de evolución de la enfermedad, lo que conlleva una elevada morbimortalidad antes y después de su tratamiento quirúrgico y/o intervencionista.

Palabras clave

aneurisma de la aorta abdominal; rotura de la aorta; fístula vascular; vena cava inferior; reparación endovascular de aneurismas.

Abstract

Within the spectrum of abdominal aortic aneurysm, various complications can arise, including the development of an arteriovenous fistula connecting this major vessel to the infrarenal inferior vena cava. This report presents the case of a 70-year-old man with sudden, intense abdominal pain and syncope, found intraoperatively to have an aortocaval fistula due to a ruptured abdominal aortic aneurysm. The patient underwent emergency care, including fistula closure and placement of a Dacron aortobifemoral graft. Aortocaval fistula is a rare complication of aortic aneurysmal disease, with clinical manifestations varying depending on disease progression, leading to high morbidity and mortality both before and after surgical or interventional treatment.

Keywords

abdominal aortic aneurysm; aortic ruptura; vascular fistula; inferior caval vein; endovascular aneurysm repair

References

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Submitted date:
10/07/2024

Accepted date:
02/08/2025

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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