[Aorto-iliocaval fistula caused by rupture of an aneurysm. Apropos of 3 cases].

Three cases of aorto-iliocaval fistula are reported. Two cases were diagnosed during operation, an emergency laparotomy being indicated by the picture of hemodynamic shock unimproved by intravenous fluids, and without reduction in number of circulating red cells, associated with a painful abdominal aorta aneurysm. Recovery occurred after surgical closure of fistula and grafting of the aneurysm. In one case a caval stenosis required the insertion of a prophylactic subrenal clip. The third case was original in that a paradoxical pulmonary embolus developed in a patient with a primary left iliac aneurysm complicated by phlebitis. The hemodynamic state was such that a first stage operation. allowed insertion of a Greenfield's filter by the jugular route. Arteriography confirmed the diagnosis of a fistula and surgery was successful. Possible clinical manifestations of aortocaval fistula and surgical therapeutic measures are discussed.