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

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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

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