case_images: PMC6837780_01
case_images: Axial contrast-enhanced computed tomography showing a large infrarenal aneurysm (star) having a fistulous communication (white diagonal arrow) on its right posterolateral wall with inferior vena cava (black arrow).
case_images: SAJR-22-1363-g001.jpg
case_images: PMC6837780_01_SAJR-22-1363-g001.jpg
case_images: F0001
case_images: AAA with a partially thrombosed periphery. Active extra luminal extravasation of contrast was seen from the right lateral wall, into the peritoneal cavity (Figures 1 and 3a). There was a fistulous communication on the right posterolateral wall of aorta with the inferior vena cava (IVC), with a flap displaced into the IVC about 4.5 cm distal to the origin of the renal arteries (Figure 1).
case_images: Axial contrast-enhanced computed tomography scan during the arterial phase showing opacification of the common iliac arteries and veins bilaterally, with similar attenuation (white arrows); layering of contrast was observed in the iliac veins (black arrow).
case_images: SAJR-22-1363-g002.jpg
case_images: PMC6837780_01_SAJR-22-1363-g002.jpg
case_images: F0002
case_images: The lower abdominal IVC and iliac veins were opacified on the arterial phase with contrast medium density similar to that of the aorta (HU 350) (Figure 2).
case_images: (a) Axial contrast-enhanced computed tomography scan demonstrating active extravasation of contrast into the peritoneal cavity (arrow). Contrast is also seen in the renal veins; (b) Contrast seen in the hepatic inferior vena cava (arrow) but with less attenuation (HU - 150) owing to reflux from right atrium.
case_images: SAJR-22-1363-g003.jpg
case_images: PMC6837780_01_SAJR-22-1363-g003.jpg
case_images: F0003
case_images: AAA with a partially thrombosed periphery. Active extra luminal extravasation of contrast was seen from the right lateral wall, into the peritoneal cavity (Figures 1 and 3a). This helped in excluding reflux of contrast from the right atrium as the cause for opacification in the lower abdominal IVC (Figure 3b).