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Diagnosis of Clinically Unsuspected Posttraumatic Arteriovenous Fistulas of the Pelvis Using CT Angiography

¹ Johns Hopkins University School of Medicine, Baltimore, MD 21287-0801.
² Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St., Rm. 3251, Baltimore, MD 21287.

OBJECTIVE. Traumatic arteriovenous (AV) fistulas present with a variety of clinical manifestations and may prove difficult to detect. The clinical sequelae of undiagnosed AV fistulas are significant and include dilatation of the vessels, venolymphatic trophic complications, and heart failure. In this article, we report two rare cases involving long-standing noniatrogenic AV fistulas of the pelvis that were detected using 64-MDCT angiography (CTA) 14 and 20 years after a trauma.

CONCLUSION. With the increased use of CTA for the diagnosis and follow-up of trauma patients, we might better detect AV fistula formation and thereby prevent the onset of sequelae normally associated with chronically undiagnosed AV fistulas.

Keywords: arteriovenous fistulas • CT • CT angiography • emergency radiology • MDCT • MDCT angiography • pelvic imaging • trauma

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