TY - JOUR
T1 - Ureteral-abdominal aortic fistula during the exchange of ureteral stenting
T2 - A case report
AU - Segawa, Naoki
AU - Hamada, Syuji
AU - Takahara, Kiyoshi
AU - Tanaka, Keitaro
AU - Daimon, Masahiro
AU - Kanehara, Hironori
AU - Suzuki, Toshiaki
AU - Iwamoto, Yusaku
AU - Tsuji, Motomu
AU - Azuma, Haruhito
AU - Okuda, Junji
AU - Katsumata, Takahiro
AU - Katsuoka, Yoji
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/8
Y1 - 2007/8
N2 - We report a case of a patient with a fistula between the left ureter and abdominal aorta. The patient was a 44-year-old male who had undergone radiation therapy (intraoperative : 25 Gy, external beam : 50 Gy) and chemotherapy (CDDP : 250 mg) for retroperitoneal lymph node metastasis from seminoma. His postoperative course was complicated by stenosis of bilateral ureters, which were treated by indwelling double J-stents. Fifteen years after the operation, gross hematuria occurred from the left ureteral orifice when exchanging the left ureteral double J-stent. Computed tomographic scan demonstrated left ureteral-abdominal aortic fistula formation at the crossing point. Massive hemorrhage was suspected to have prompt fistula formation between the left ureter and the aorta. At exploration, there was a fistula of about 7 mm in diameter at the anterior surface of the aorta, and the stent was presumably inserted from it. The aortic fistula was successfully closed. In addition, the left ureter was ligated proximal to the fistula and percutaneous left nephrostomy were performed. His postoperative course was uneventful. We should be aware that uretero-arterial fistula can occur as a serious complication of ureteral catheter exchange after prolonged ureteral stenting and radiation therapy.
AB - We report a case of a patient with a fistula between the left ureter and abdominal aorta. The patient was a 44-year-old male who had undergone radiation therapy (intraoperative : 25 Gy, external beam : 50 Gy) and chemotherapy (CDDP : 250 mg) for retroperitoneal lymph node metastasis from seminoma. His postoperative course was complicated by stenosis of bilateral ureters, which were treated by indwelling double J-stents. Fifteen years after the operation, gross hematuria occurred from the left ureteral orifice when exchanging the left ureteral double J-stent. Computed tomographic scan demonstrated left ureteral-abdominal aortic fistula formation at the crossing point. Massive hemorrhage was suspected to have prompt fistula formation between the left ureter and the aorta. At exploration, there was a fistula of about 7 mm in diameter at the anterior surface of the aorta, and the stent was presumably inserted from it. The aortic fistula was successfully closed. In addition, the left ureter was ligated proximal to the fistula and percutaneous left nephrostomy were performed. His postoperative course was uneventful. We should be aware that uretero-arterial fistula can occur as a serious complication of ureteral catheter exchange after prolonged ureteral stenting and radiation therapy.
UR - http://www.scopus.com/inward/record.url?scp=34548834147&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548834147&partnerID=8YFLogxK
M3 - Article
C2 - 17874549
AN - SCOPUS:34548834147
VL - 53
SP - 565
EP - 569
JO - Acta Urologica Japonica
JF - Acta Urologica Japonica
SN - 0018-1994
IS - 8
ER -