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[Uretero-external iliac artery fistula: a case report]
G Kawabata1, N Yamanaka, H Shimogaki
1Division of Urology, Shinko Hospital.
Hinyokika Kiyo. Acta Urologica Japonica
|January 20, 1999
Summary
This case report details a rare uretero-external iliac artery fistula in a patient with a history of cervical cancer treatment. Prompt diagnosis and surgical intervention were crucial for successful management.
Area of Science:
- Urology
- Vascular Surgery
- Oncology
Background:
- A 60-year-old female with a history of advanced cervical cancer treated with hysterectomy, radiation, and chemotherapy presented with intermittent gross macrohematuria.
- The patient had a left ureteral double-J stent in place for left hydronephrosis.
Observation:
- Retrograde urography revealed a filling defect in the left ureter.
- Contrast-enhanced CT scan showed left hydronephrosis and hydroureter, but no definitive fistula or extravasation.
- Pelvic arteriography identified a pseudoaneurysm of the left external iliac artery at the ureter's crossing point.
Findings:
- A rare uretero-external iliac artery fistula was diagnosed.
- Surgical repair of the fistula and left nephroureterectomy were successfully performed.
Implications:
- This case highlights the importance of considering uretero-arterial fistula in patients with a history of pelvic radiation and indwelling ureteral stents.
- Vascular complications, such as pseudoaneurysms and fistulas, can occur long after radiation therapy.
- Multimodality imaging, including arteriography, is essential for diagnosing such rare conditions.