Open AccessA rare case of paradoxical pulmonary embolism in spontaneous aortocaval fistula
Author(s) -
Valentina Vespro,
Stefano Fusco,
Anna Maria Ierardi,
Viviana Grassi,
Ilenia D’Alessio,
S. Crespi,
Maria Carmela Andrisani,
A. Bellobuono,
Santi Trimarchi,
Gianpaolo Carrafiello
Publication year - 2021
Publication title -
bjr case reports
Language(s) - English
Resource type - Journals
ISSN - 2055-7159
DOI - 10.1259/bjrcr.20200183
Subject(s) - medicine , pulmonary embolism , inferior vena cava , abdominal aortic aneurysm , complication , radiology , abdominal pain , fistula , surgery , embolism , arteriovenous fistula , aneurysm
Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA), occurring in less than 1% of all AAAs. Paradoxical embolism can rarely be associated with ACF, pulmonary embolism may originate from dislodgment of thrombotic material from the AAA in the inferior vena cava (IVC) through the ACF. We report a case of a patient admitted to the emergency department with abdominal pain and shortness of breath who immediately underwent thoraco-abdominal CT. Imaging allowed a prompt pre-operative diagnosis of an ACF between an AAA and the IVC, also identifying CT signs of right heart overload and the presence of a paradoxical pulmonary embolism.