Document Detail


A case of iliac-artery-ureteral fistula managed with a combined endoscopic approach.
MedLine Citation:
PMID:  18334976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A 66-year-old man presented to hospital with gross hematuria and clots. He had previously undergone surgical repair of a right iliac artery aneurysm with placement of a vascular prosthesis at the same hospital, which had resulted in iliac urethral stricture that required the placement of a right ureteral stent. He had attended repeatedly for recurrent ureteral stent replacement, with the most recent replacement having occurred 1 month before the current presentation. INVESTIGATIONS: Ultrasonography, cystography, retrograde pyelography and provocative arteriography via a percutaneous right femoral arterial approach. DIAGNOSIS: An iliac-artery-ureteral fistula between the right ureter and a pseudoaneurysm of the right common iliac artery. MANAGEMENT: The patient underwent placement of a covered, self-expandable vascular stent with angioplasty balloon, which resulted in complete exclusion of the pseudoaneurysm and fistula and resolution of the patient's hematuria. A pigtail catheter was placed in the right ureter for 5 days and replaced with a double-J ureteral stent on day 6 after exclusion of the pseudoaneurysm; the patient was discharged from hospital on the same day. Color-Doppler ultrasonography of the right iliac vessels performed 2 months later showed patency of the right iliac artery. The patient's ureteral stent has been replaced every 2 months since his discharge without recurrence of hematuria.
Authors:
Fabrizio Gallo; Emilio Gastaldi; Gianpiero Spirito; Antonio Barile; Corrado Kosir; Claudio Giberti
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-03-11
Journal Detail:
Title:  Nature clinical practice. Urology     Volume:  5     ISSN:  1743-4289     ISO Abbreviation:  -     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101226508     Medline TA:  Nat Clin Pract Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-8     Citation Subset:  IM    
Affiliation:
Division of Urology, San Paolo Hospital, Savona, Italy. gallo.fabrizio@fastwebnet.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, False / diagnosis,  therapy
Angioplasty, Balloon
Hematuria / etiology
Humans
Iliac Artery / surgery*
Male
Stents
Ureter / surgery*
Urinary Fistula / diagnosis,  therapy*
Vascular Fistula / diagnosis,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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