An Unusual Cause of Hematuria and Flank Pain

Hematuria and flank pain are a typical urology emergency, often presented as the primary complaint. However, in patients with previous aortolia surgery, these symptoms may rarely indicate external compression of the urinary tract by an anastomotic pseudoaneurysm. We herein describe an unusual case of a 50-year-old man who presented to the urologist with hematuria and right flank pain due to ureteric compression by an aortic anastomotic pseudoaneurysm. He had undergone an open aortolia revascularization procedure with a bifurcated graft 9 years earlier and the pseudoaneurysm was found at the proximal anastomosis pressurizing the right ureter. The patient was successfully treated with a pigtail placement and an endograft implantation resulting in resolution of his symptoms. Urological symptoms in patients with a history of previous aortolia surgery should raise the suspicion of an anastomotic pseudoaneurysm.