Rupture of an aortic anastomotic aneurysm into a ureter

A case of rupture of a false aneurysm of the distal aorta into the left ureter is reported. The patient presented with purulent hydronephrosis and hematuria. A left aorto-femoral graft had been inserted 3 years earlier, which became infected and was then removed. After 2 years a false distal aortic aneurysm developed, and in the last 6 months recurrent episodes of hematuria have occurred. An aorto-ureteric fistula was confirmed at surgery, and a left nephrostomy was performed with proximal and distal ligation of the ureter and then aneurysmectomy followed by aorto-bifemoral bypass.