Ruptured abdominal aortic aneurysm with aortocaval fistula and embolic IVC thrombus—a rare clinical scenario detected on CT angiography

Rupture with fistulization of an abdominal aortic aneurysm with the vena cava is a rare complication and typically presents with congestive cardiac failure. Embolization of a thrombus from the aneurysm into the vena cava can however present in the absence of failure symptoms which can make it difficult to diagnose clinically without cross sectional imaging.