Cardiac consequence of misdiagnosed vascular complication of spinal lumbar surgery: 6 years of diagnosis delay.

Ilio-caval fistula is a rare complication of lumbar disk surgery that may pose a real diagnostic challenge. We report a case of a 50-year-old woman with overlooked massive right ilio-caval fistula complicating lumbar surgery 6 years previously, and who presented with refractory right heart failure misdiagnosed as chronic pericarditis. The combination of right heart failure and a periumbilical murmur should alert clinicians to investigate with the appropriate imaging tests to confirm the diagnosis. <Learning objective: Ilio-caval fistula is a rare vascular complication of low lumbar disk surgery often overlooked, which explains the frequency of late discovery cases due to the semiological polymorphism of the presentation. The combination of right heart failure and a periumbilical murmur should alert clinicians to investigate with the appropriate imaging tests to confirm the diagnosis. The treatment could be based on surgery or endovascular intervention; the prognosis remains good in treated patients.>.