Aorto-caval fistula mimicking severe liver disease – Problems and possibilities of EVAR in a ruptured aortic aneurysm -

Purpose: To show primary and secondary symptoms and diagnostic problems of a high flow aorto-caval fistula. Material and methods: A 60 year old male was admitted to hospital due to severe pulmonary hypertension (PH), cardiomegaly and liver cirrhosis with ascites. Cardiac output was elevated up to 12 l/min. CT and Color coded duplex sonography (CCDS) without and with contrast (CEUS) are compared with angiography. LFTs and elastography (Shear wave technique) were controlled over more than 6 months. Results: CT showed an infra-renal aneurysm of 8 × 9 cm with early filling by contrast misinterpreted as a sign of tri…