Ureteroarterial Fistula
Ureteral-iliac artery fistula (UIAF) is a rare life threatening cause of hematuria. The increasing frequency is attributed to increasing use of ureteral stents. A 68-year-old female presented with gross hematuria. She had prior low anterior resection for rectal cancer and a retained ureteral stent....
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| Format: | Article |
| Language: | English |
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Wiley
2009-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2009/326969 |
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| author | D. H. Kim A. Mahdy V. Mundra M. Berman G. M. Ghoniem |
| author_facet | D. H. Kim A. Mahdy V. Mundra M. Berman G. M. Ghoniem |
| author_sort | D. H. Kim |
| collection | DOAJ |
| description | Ureteral-iliac artery fistula (UIAF) is a rare life threatening cause of hematuria. The increasing frequency is attributed to increasing use of ureteral stents. A 68-year-old female presented with gross hematuria. She had prior low anterior resection for rectal cancer and a retained ureteral stent. CT abdomen and pelvis showed a large recurrent pelvic mass and a retained stent. The patient underwent cystoscopy which showed a normal bladder. Upon removal of the stent, brisk bleeding was noted coming from the ureteral orifice. Antegrade pyelogram was done which revealed a UIAF. Angiography was done and a covered stent was placed. Multiple treatment options are available. All must consider management of the arterial and ureteral side. The arterial side may be addressed by primary open repair, embolization with extra-anatomic vascular reconstruction, or endovascular stenting. The ureter can be managed with nephroureterectomy, ureteral reconstruction, placement of a nephrostomy tube, or ureteral stenting. Being minimally invasive, we believe that endovascular stenting should be the preferred therapeutic option as it also corrects the source of bleeding while preserving distal blood flow. |
| format | Article |
| id | doaj-art-050f2e27cabc4f9ab287e655f3232116 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-050f2e27cabc4f9ab287e655f32321162025-02-03T01:23:52ZengWileyCase Reports in Medicine1687-96271687-96352009-01-01200910.1155/2009/326969326969Ureteroarterial FistulaD. H. Kim0A. Mahdy1V. Mundra2M. Berman3G. M. Ghoniem4Department of Urology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd. Weston, FL 33331, USADepartment of Urology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd. Weston, FL 33331, USADepartment of Internal Medicine, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd. Weston, FL 33331, USADepartment of Radiology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd. Weston, FL 33331, USADepartment of Urology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd. Weston, FL 33331, USAUreteral-iliac artery fistula (UIAF) is a rare life threatening cause of hematuria. The increasing frequency is attributed to increasing use of ureteral stents. A 68-year-old female presented with gross hematuria. She had prior low anterior resection for rectal cancer and a retained ureteral stent. CT abdomen and pelvis showed a large recurrent pelvic mass and a retained stent. The patient underwent cystoscopy which showed a normal bladder. Upon removal of the stent, brisk bleeding was noted coming from the ureteral orifice. Antegrade pyelogram was done which revealed a UIAF. Angiography was done and a covered stent was placed. Multiple treatment options are available. All must consider management of the arterial and ureteral side. The arterial side may be addressed by primary open repair, embolization with extra-anatomic vascular reconstruction, or endovascular stenting. The ureter can be managed with nephroureterectomy, ureteral reconstruction, placement of a nephrostomy tube, or ureteral stenting. Being minimally invasive, we believe that endovascular stenting should be the preferred therapeutic option as it also corrects the source of bleeding while preserving distal blood flow.http://dx.doi.org/10.1155/2009/326969 |
| spellingShingle | D. H. Kim A. Mahdy V. Mundra M. Berman G. M. Ghoniem Ureteroarterial Fistula Case Reports in Medicine |
| title | Ureteroarterial Fistula |
| title_full | Ureteroarterial Fistula |
| title_fullStr | Ureteroarterial Fistula |
| title_full_unstemmed | Ureteroarterial Fistula |
| title_short | Ureteroarterial Fistula |
| title_sort | ureteroarterial fistula |
| url | http://dx.doi.org/10.1155/2009/326969 |
| work_keys_str_mv | AT dhkim ureteroarterialfistula AT amahdy ureteroarterialfistula AT vmundra ureteroarterialfistula AT mberman ureteroarterialfistula AT gmghoniem ureteroarterialfistula |