Aorto-left renal vein fistula: Diagnosis by duplex sonography

In this case, the abdominal aortic aneurysm was initially diagnosed by sonography. The routine preoperative CT study was done to detect associated iliac aneurysms, venous anomalies, and other intraabdominal disease. The retroaortic left renal vein and enlarged nonfunctioning left kidney were incidental findings. Abdominal bruit on physical exam is reported in most paitents with aortovenous fistula; however, this finding does not exclude other diseases. Although the arteriogram documented an aortovenous fistula, the exact location of the fistula could not be ascertained by angiography alone. Duplex sonography confirmed the presence of the arteriovenous fistula and established its exact location.