Aorto-caval fistula: a clinical spectrum.

Ten cases of aortocaval fistula (ACF) associated with abdominal aortic aneurysm (AAA) were reviewed. In 5 cases the ACF became apparent after evacuation of the thrombus; only 5 patients presented with features of patent ACF. Four patients in addition presented with extra-caval rupture of the aneurysm.

Dopamine and the aged.

Regardless of the age of the patient, dopamine is a valuable agent for treating shock associated with an abdominal catastrophe. However, when the time is appropriate for withdrawal of dopamine, the aged do not react as do younger patients. Despite apparent adequate hydration, additional volume loading is required to avert renal failure, and the dosage of dopamine has to be decreased gradually until withdrawal is complete.