Primary arteriovenous fistulas of the abdomen. Their occurrence secondary to aneurysmal disease of the aorta and iliac arteries.

We present three cases of arteriovenous fistula secondary to aneurysmal disease. The first patient, a 75-year-old man, presented with abdominal pain, a large pulsatile mass, and renal failure. He underwent repair of his aortocaval fistula; his renal failure resolved and the remainder of his course was uneventful. The second patient, a 77-year-old man, presented with a several-day history of nausea, lower abdominal pain, and a pulsatile mass. He underwent repair of his aortocaval fistula but died on the 21st postoperative day of progressive pulmonary failure. The third patient, a 76-year-old man, presented with an episode of syncope and subsequent rapid development of left lower extremity edema. He was subsequently found to have a right iliac artery to left iliac vein fistula, which was repaired. He did well postoperatively with gradual resolution of his lower extremity edema.