Aneurysmal dilatation of the right renal vein for arterovenous fistula as a late consequence of open renal surgery

We report a case of right renal arterial-venous (A-V) fistula, probably related to injury of renal blood vessels during open surgery for renal stones performed eight years ago, presenting with symptoms of congestive heart failure and chronic renal failure. On physical examination a palpable abdominal pulsatile mass in the right upper quadrant, associated with a continuous thrill was appreciated. The computed tomographic (CT) scan and the selective renal angiography showed the shunt between the renal vessels and the subsequent aneurysmal dilatation of right renal vein. Prompt and significant improvement of congestive heart and chronic renal failure was documented after right nephrectomy