Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492007000300016
Jornal Vascular Brasileiro
Case Report

Aneurisma ilíaco associado a fístula arteriovenosa

Iliac aneurysm associated with arteriovenous fistula

Daniel Mendes Pinto; Leonardo Ghizoni Bez; José Olimpio Dias Júnior; Caetano de Sousa Lopes; Ari Mandil

Downloads: 0
Views: 878

Resumo

A ruptura dos aneurismas aorto-ilíacos para a veia ilíaca ou veia cava é uma complicação pouco comum. A hipertensão venosa leva a vários sinais e sintomas, o que dificulta o diagnóstico pré-operatório, tais como edema do membro inferior, dispnéia, hematúria, sinais de insuficiência renal ou cardíaca. Sopro abdominal é a chave do diagnóstico clínico, associado à massa pulsátil e dor abdominal. O reconhecimento da fístula arteriovenosa no pré-operatório é importante para o planejamento cirúrgico. Relatamos um caso de aneurisma da artéria ilíaca comum e interna direita associado a fístula para veia ilíaca comum, cursando, inicialmente, com edema do membro inferior direito e dispnéia, o que levou ao diagnóstico incorreto de trombose venosa profunda.

Palavras-chave

Aneurisma ilíaco, fístula arteriovenosa, aneurisma roto

Abstract

Rupture of aortoiliac aneurysms into the iliac vein or vena cava is an uncommon complication. Many signs and symptoms develop as a result of venous hypertension, which makes preoperative diagnosis difficult, such as leg edema, dyspnea, hematuria, signs of renal or cardiac insufficiency. Abdominal bruit, associated with pulsatile mass and abdominal pain, is the key for clinical diagnosis. Preoperative recognition of arteriovenous fistula is important for surgical planning. We report a case of right internal and common iliac artery aneurysm associated with fistula into the common iliac vein. Initial symptoms were right leg edema and dyspnea, which induced to the incorrect diagnosis of deep vein thrombosis.

Keywords

Iliac aneurysm, arteriovenous fistula, ruptured aneurysm

References

Baker WH, Sharzer LA, Ehrenhaft JL. Aortocaval fistula as a complication of abdominal aortic aneurysms. Surgery. 1972;72:933-8.

Schmidt R, Bruns C, Walter M, Erasmi H. Aorto-caval fistula--an uncommon complication of infrarenal aortic aneurysms. Thorac Cardiovasc Surg.. 1994;42:208-11.

Miani S, Giorgetti PL, Arpesani A, Giuffrida GF, Biasi GM, Ruberti U. Spontaneous aorto-caval fistulas from ruptured abdominal aortic aneurysms. Eur J Vasc Surg.. 1994;8:36-4.

Davidovic LB, Kostic DM, Cvetkovic SD. Aorto-caval fistulas. Cardiovasc Surg.. 2002;10:555-60.

Hardin CA. Ruptured abdominal aneurysm occurring in Marfan's syndrome: attempted repair with the use of a nylon prosthesis. N Engl J Med.. 1959;260:821-2.

Lynch HT, Larsen AL, Wilson R, Magnuson CL. Ehlers-Danlos syndrome and "congenital" arteriovenous fistulae: a clinicopathologic study of a family. JAMA. 1965;194:1011-4.

Gronemeyer PS, de Mello DE. Takayasu's disease with aneurysm of right common iliac artery and iliocaval fistula in a young infant: case report and review of the literature. Pediatrics. 1982;69:626-31.

Jarstfer BS, Rich NM. The challenge of arteriovenous formation following disk surgery: a collective review. J Trauma. 1976;16:726-33.

Machiedo GW, Jain KM, Swan KG, Petrocelli JC, Blackwood JM. Traumatic aorto-caval fistula. J Trauma. 1983;23:243-7.

Mattox KL, Whisennand HH, Espada R, Beall AC. Management of acute combined injuries to the aorta and inferior vena cava. Am J Surg.. 1975;130:720-4.

Cinara IS, Davidovic LB, Kostic DM, Cvetokvic SD, Jakovljevic NS, Koncar IB. Aorto-caval fistulas: a review of eighteen years experience. Acta Chir Belg.. 2005;105:616-20.

Davis PM, Gloviczki P, Cherry KJ. Aorto-caval and ilio-iliac arteriovenous fistulae. Am J Surg.. 1998;176:115-8.

Bonamigo T, Siliprandi LR. Diagnóstico do aneurisma da aorta abdominal. Rev Med Santa Casa. 1990;1:186-93.

Carvalho ATY, Prado V, Neto HJG, Caffaro RA. Aspectos cirúrgicos dos aneurismas isolados das artérias ilíacas. J Vasc Bras.. 2006;5:203-8.

Weinbaum FI, Riles TS, Imparato AM. Asymptomatic vena cava fistulization complicating abdominal aortic aneurysm. Surgery. 1984;96:126-8.

Brewster DC, Cambria RP, Moncure AC. Aortocaval and iliac arteriovenous fistulas: recognition and treatment. J Vasc Surg.. 1991;13:253-64.

Brewster DC, Ottinger LW, Darling RC. Hematuria as a sign of aorto-caval fistula. Ann Surg.. 1977;186:766-71.

Adili F, Balzer JO, Ritter RG. Ruptured abdominal aortic aneurysm with aorto-caval fistula. J Vasc Surg.. 2004;40:582.

Williamson AE, Annunziata G, Cone LA, Smith J. Endovascular repair of a ruptured abdominal aortic and iliac artery aneurysm with an acute iliocaval fistula secondary to lymphoma. Ann Vasc Surg.. 2002;16:145-9.

Vetrhus M, McWilliams R, Tan CK, Brennan J, Gilling-Smith G, Harris PL. Endovascular repair of abdominal aortic aneurysms with aortocaval fistula. Eur J Vasc Endovasc Surg.. 2005;30:640-3.

Umscheid T, Stelter WJ. Endovascular treatment of an aortic aneurysm ruptured into the inferior vena cava. J Endovasc Ther.. 2000;7:31-5.

Lau LL, O'reilly MJ, Johnston LC, Lee B. Endovascular stent-graft repair of primary aortocaval fistula with an abdominal aortoiliac aneurysm. J Vasc Surg.. 2001;33:425-8.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddec1b30e88251f197279a1 jvb Articles

J Vasc Bras

Share this page
Page Sections