Uretero-Iliac artery fistula: a rare cause of haematuria
| Autor: | Raj Satkunasivam, Natalia Hernandez, Eric K. Peden, Bethany Desroches |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography Urinary Fistula Ureterectomy Fistula medicine.medical_treatment Uterine Cervical Neoplasms urologic and male genital diseases Iliac Artery Resection Rare Disease Humans Medicine Radiation Injuries Hematuria Nephrostomy Percutaneous Vascular Fistula Iliac artery medicine.diagnostic_test urogenital system business.industry Endovascular Procedures Chemoradiotherapy General Medicine Middle Aged Vascular surgery medicine.disease female genital diseases and pregnancy complications Surgery Radiation therapy surgical procedures operative Percutaneous nephrostomy Angiography Female Stents Vascular Grafting Urinary Catheterization business Ureteral Obstruction |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A woman in her mid-forties with a history of cervical cancer requiring chemoradiation presented with bilateral ureteral strictures secondary to radiation therapy. The ureteral obstruction was initially relieved with bilateral percutaneous nephrostomy tubes, and subsequently, bilateral ureteral stents. Over the course of 8 months, she presented with multiple episodes of severe gross haematuria. This persisted even after stent removal and conversion back to percutaneous nephrostomy tubes. The initial evaluation, done with concern for an uretero-iliac artery fistula, which included bilateral retrograde pyelograms and CT angiography was non-diagnostic. Given continued haematuria, repeat endoscopic evaluation was undertaken; on retrograde pyelogram, brisk contrast was seen to pass into the arterial system, consistent with a left ureteroarterial fistula. The patient underwent endovascular iliac artery stent placement. Subsequently, the patient underwent resection of the iliac artery with endovascular graft in situ, left distal ureterectomy with proximal ureteral ligation following femoral-to-femoral bypass. This allowed for complete resolution of the patient’s gross haematuria episodes. |
| Databáze: | OpenAIRE |
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