This is a case of post-traumatic aorto-left renal vein fistula. Fistulas between the aorta and the left renal vein are extremely rare. It most cases, this pathological communication results as a complication of abdominal aortic aneurysms, mostly when a retroaortic left renal vein is present. It is less commonly seen as a post-traumatic or post-surgical complication since simultaneous injury to both vessels (aorta and left renal vein) is necessary for it to form.