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Ureteral perigraft fistula.

Samuel Deem¹, Patrick Stone, Chris Schlarb

¹Department of Surgery, West Virginia University-Charlston Division Charleston, WV 25304, USA. samuel_deem@yahoo.com

Vascular and Endovascular Surgery

|August 21, 2007

Summary

Ureteral perigraft fistula, a rare complication after aortic surgery, presented as hematuria. Initial diagnosis was ureteral-arterial fistula, but imaging revealed a ureteral perigraft fistula, requiring further management.

Area of Science:

Urology
Vascular Surgery
Radiology

Background:

Ureteral injury is a rare complication of aortic surgery (<1%).
Ureteral-arterial fistulae are exceptionally rare, documented primarily in case reports.
A history of aortic graft surgery increases the risk of ureteral complications.

Observation:

A patient presented with acute hematuria and a history of aortic bifemoral graft.
Cystoscopy and retrograde pyelogram suggested a fistula between the left ureter and the aortic graft.
Radiographic review clarified the diagnosis as a ureteral perigraft fistula.

Findings:

The case highlights a rare ureteral perigraft fistula, distinct from a ureteral-arterial fistula.
Radiographic findings are crucial for differentiating these conditions.

Related Experiment Videos

Conservative management was initially suggested but ultimately insufficient.

Implications:

This case expands the understanding of ureteral complications post-aortic surgery.
Accurate radiographic diagnosis is vital for appropriate patient management.
Further research into the incidence and management of ureteral perigraft fistulae is warranted.