Acute liver failure revealing aorto-caval fistula

We report the case of a 49-year-old woman with an aorto-caval fistula following lumbar diskectomy. Initial symptoms included isolated hepatalgia, and were later associated with jaundice and hepatomegaly, suggesting acute liver failure due to right heart failure. Only 9 previous cases of postoperative aorto-caval fistula have been reported and our case emphasizes the possibility of a pseudo-digestive presentation of high output arteriovenous fistula.