Aortocaval Fistula Presenting with Hematuria and Renal Failure

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We present a case of a fistula involving the inferior vena cava and an abdominal aortic aneurysm, associated with hematuria and renal failure and which proved fatal. A clinical diagnosis is sometimes difficult because the classic diagnostic signs (pulsatile abdominal mass with bruit, high-output heart failure and low back pain) may be absent in many cases. Nowadays a contrast-enhanced spiral computed tomography scan is usually sufficient to diagnose this pathology.