[Arterio-venous fistula of the left renal pedicle after nephrectomy. Possibilities and interest of early diagnosis (author's transl)]

Abstract

The authors study a new case of arterio-venous fistula of the left renal pedicle after nephrectomy for trauma. The interest of this case resides in the existence of a right para-umbilical pulsating mass which corresponds to systolic expansion of the inferior vena cava. This sign, which disappeared after corrective operation has the advantage of orienting towards an abdominal vascular condition. In fact, the diagnosis of iatrogenic arterio-venous fistula was made very early : 6 weeks after nephrectomy. The lesion was treated by the purely abdominal route, in the absence of marked peri-aneurysmal fibrosis. Complete removal of the fistula and of the afferent and efferent vessels corrects recent hypertension and prevents later heart failure.