A 34-year-old man, who had got a stab wound on the abdomen and undergone an abdominal surgery 12 years ago during his military service, visited the hospital because of occipital headache and known hypertension for 5 years.

On examination, his blood pressure was 200/140mmhg, and a thrill and loud continuous vascular bruits over the paraumbilical and right loin region were noted. his blood pressure was refractory to usual antihypertensive regimens.

The chest X-ray film showed cardiac enlargement and pulmonary congestion. With the aids of abdominal ultrasonogram, static and dynamic renal scanning with ^99mT-DTPA, excretory urogram, aortogram and selective right renal angiogram, he was diagnosed as right renal artery inferior vena cava fistula.

After fistulectomy and repair of walls of both vessels, his blood pressure was successfully controlled with drugs.