Images in medicine: Spontaneous aortocaval fistula complicating abdominal aortic aneurysm

Aortocaval fistula represents a rare, life-threatening complication of abdominal aortic aneurysm that needs emergency surgical treatment. The presentation couples that of a rupturing aneurysm with other more characteristic features resulting from the massive arteriovenous shunt. Early recognition and emergency surgical treatment are essential in reducing mortality and morbidity. Prompt investigation with multidetector computed tomography (CT) angiography quickly and accurately establishes a precise preoperative diagnosis, thereby enabling proper planning of operative treatment.