Iliac arteriovenous fistula with renal insufficiency, ascites, hepatomegaly, and abnormal liver test results.

Division of General Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.

Arteriovenous fistula presents rarely with liver involvement. A 73-year-old man had new-onset ascites, hepatomegaly, and abnormal liver and renal function test results. An abdominal computed tomogram revealed a 7.6-cm internal iliac aneurysm but no other abnormality to account for his ascites. An aortogram demonstrated a 1.5-cm internal iliac arteriovenous fistula that subsequently was repaired, leading to resolution of his symptoms and laboratory abnormalities. High-output cardiac failure should be considered in the differential diagnosis of patients with new-onset massive ascites, hepatomegaly, and liver test abnormalities.

PMID: 11393508 [PubMed - indexed for MEDLINE]