Carotid-jugular fistula diagnosed by transesophageal echocardiography.

Arteriovenous fistulas (AVFs) in the neck are rare, and are most frequently caused by internal jugular catheter placement or penetrating trauma. Diagnosis can be missed when pathognomonic physical exam findings are absent, and heart failure can develop late when AVFs go unrepaired. We present what we believe to be the first reported case of common carotid-internal jugular fistula diagnosed during transesophageal echocardiography. Causes, physical exam findings, complications, diagnostic imaging, and treatment are discussed.