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Uretero-arterial fistula: two observations
H Van Damme1, V Keppenne, N Sakalihasan
1Department of Cardiovascular Surgery, University Hospital Sart-Tilman, Liège, Belgium.
Acta Chirurgica Belgica
|June 1, 1997
Summary
Uretero-arterial fistula can cause life-threatening bleeding, often linked to prior surgeries or urinary issues. Early diagnosis and surgical intervention are crucial for successful treatment of this rare condition.
Area of Science:
- Urology
- Vascular Surgery
- Medical Case Reports
Background:
- Uretero-arterial fistula is a rare but severe condition causing significant hematuria.
- Predisposing factors include prior vascular surgery, aneurysms, ureteral stents, and obstructive uropathy.
Observation:
- Two cases of life-threatening hematuria secondary to uretero-arterial fistula are presented.
- Case 1: Aorto-bifemoral bypass, iliac artery aneurysm, and ureteral stent.
- Case 2: Previous aortoiliac surgery, obstructive uropathy, and chronic urinary tract infection.
Findings:
- Preoperative diagnosis was achieved in only one case.
- Successful surgical management (iliac aneurysm exclusion) was performed in one patient.
- The other patient underwent nephrectomy, but experienced fatal recurrent bleeding.
Implications:
- Highlights the diagnostic challenges and critical importance of timely intervention for uretero-arterial fistulas.
- Emphasizes the need to consider uretero-arterial fistula in patients with relevant risk factors presenting with severe hematuria.
- Discusses contributing factors, diagnostic strategies, and optimal treatment approaches for this uncommon vascular complication.