Congestive heart failure and lower extremity edema as late sequelae of unrecognized iliac arteriovenous fistula

Sa？etak We report a case of a female patient with a large volume iliac arteriovenous fistula. She presented with severe congestive heart failure and unilateral leg edema. Six years before present admission she underwent surgery because of the lumbar disc protrusion. Diagnosis was delayed due to the overshadowing symptoms of co-existent aortic valve insufficiency. Contrast-enhanced multislice computed tomography with three-dimensional reconstruction confirmed the diagnosis. The fistula was closed by using an open surgical approach, and the patient completely recovered. Severe late consequences of unrecognized arteriovenous fistula are emphasized. Causes for delayed recognition of underlying pathology, as well as diagnostic and treatment options are discussed