Noninvasive diagnosis of fistula from abdominal aortic aneurysm to the inferior vena cava. Case report.

Rupture into the inferior vena cava was found in three (1.4%) of 211 abdominal aortic aneurysms operated on in an 18-year period, and in 4.4% of all 68 cases in which the aneurysm had ruptured. One of the three patients initially presented with isolated chest symptoms. All three survived surgical repair, though major bleeding occurred in one. Preoperative recognition of the characteristic clinical features of an aortocaval fistula is important. Computed tomography and ultrasound studies were used to confirm the diagnosis and visualize the anatomy before the operation in one case.