[Abdominal arteriovenous fistula due to rupture of aorto-iliac aneurysm with multivarious clinical manifestations. Report of a case with successful repair].

We present a 63-year old man with the arteriovenous fistula caused by the rupture of the aneurysm which extended from the abdominal aorta to the bilateral internal iliac arteries. The clinical manifestations included edema of the left lower extremity, pulmonary embolism, high-output congestive heart failure, origulia, azotemia, liver dysfunction and unstable angina. Because of the variety of the clinical symptoms and the lack of the awareness of this rare complication (arteriovenous fistula), we missed the prompt detection of the entity of the abdominal arteriovenous fistula. We finally succeeded the surgical closure of the fistula and the aortic reconstruction with a woven Dacron bifarcation graft. Problems of diagnosis and operative management are discussed.