Presentation
Patient history of raised CA 19.9 and CA 125 tumor markers. Presented with shortness of breath and heart palpitations.
Patient Data
A communication between the right common femoral artery and vein in the right groin.
Arterialization of the right external iliac and right common iliac veins causing arterial blood shunting into the vein.
There is an arteriovenous fistula of the right common femoral artery and vein in the right groin.
Case Discussion
The femoral artery is a major blood vessel supplying blood to the upper thigh near the groin, with the common femoral vein collecting the venous blood. Generally they are separate in the vascular system, but in an arteriovenous fistula, they are connected as a result of surgery, congenitally or injury/trauma. They are an uncommon connection, but traumatic arteriovenous fistulas generally occur in the lower extremities. Vascular punctures are a cause of traumatic arteriovenous fistulas as the pressure of arterial blood is higher than that of the vein, causing a pressure gradient. A palpable thrill and venous hypertension signs are common presentations of an arteriovenous fistula 1.
The CT indicating contrast in the right common femoral vein due to arterialization of the external and common iliac veins were suggestive of a possible arteriovenous fistula and further confirmed by a doppler ultrasound.
Case courtesy of Dr Zane Sherif.