Unilateral Leg Oedema in Association with an Aortocaval Fistula

The study considers a case of a patient who presented with scrotal and unilateral leg oedema secondary to an aortocaval fistula (ACF) complicating an abdominal aortic aneurysm (AAA). During the operation, caval blood loss was controlled with digital pressure over the fistula, and direct closure performed using a 3/0 prolene suture. The aneurysm repair was carried out with a woven Dacron® graft. The possibility of an ACF in the presence of AAAs should be considered when examining a patient with intractable unilateral leg oedema. The successful outcome depends on early preoperative recognition, prompt surgical repair and careful attention to intra-operative blood loss.