Aortocaval fistula is a rare complication of rupture of an aortic aneurysm into the inferior vena cava. Prompt surgical repair is mandatory for salvage. Emergency surgery was performed in 2 cases of aortocaval fistula. The underlying etiology was polyarteritis nodosa in one patient and atherosclerosis in the other. Polyarteritis nodosa leading to abdominal aortic aneurysm with aortocaval fistula is reported for the first time.
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