Aortic Fistulas—A Pictorial Review

Introduction: Aortic fistulas are a rare and potentially devastating complication of aortic aneurysms and inflammatory/infective conditions of the aorta. Without prompt surgical intervention, the associated mortality reaches 100%. Rapid diagnosis is essential to reduce the operative mortality.

Method(s): Clinical signs are often nonspecific and may not be present, therefore imaging is necessary to achieve an accurate diagnosis. Ultrasound and CT are often used as first line investigations in suspected aortic fistulas. Ultrasound has its known limitations. CT is seen as the optimum imaging modality due to its widespread availability and speed of use in the emergency setting. To be able to effectively diagnose aortic fistulas the radiologist must be familiar with the spectrum of CT appearances.

Result(s): Aortic fistulas are subdivided into primary and secondary etiologies. In this pictorial review, we will present a series of cases to illustrate the key imaging findings of range of aortic fistulas including: aortocaval, aortoenteric and aortoesophageal fistulas.

Conclusion(s): An aortic fistula is a rare and life-threatening condition, prompt recognition of the imaging appearances can improve patient outcomes.

Publication History

Article published online:
09 February 2023