ASYMPTOMATIC ARTERIOVENOUS FISTULA OF THE LUNG

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Abstract
THE RECOGNITION of pulmonary arteriovenous fistula, once thought to be extremely rare, is now reported with increasing frequency. To date there have been at least 53 cases diagnosed, and in 33 of these operation has been performed.1Since a pulmonary arteriovenous fistula is amenable to surgical cure, particularly if uncomplicated, the establishment of an early and correct diagnosis becomes important. A group of signs and symptoms has been built around the diagnosis of a pulmonary arteriovenous fistula. The clinician is alerted to this diagnosis whenever a patient, in the absence of congenital heart disease, presents himself with cyanosis, clubbing of the fingers and toes, and polycythemia. It is not sufficiently appreciated, however, that an arteriovenous fistula of the lung can present, at times, an entirely asymptomatic clinical picture. It may masquerade, for example, as a benign-appearing shadow in the pulmonary parenchyma detected only by chance roentgenograms. It is the

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