Ureteral-abdominal aortic fistula during the exchange of ureteral stenting

A case report

Naoki Segawa, Syuji Hamada, Kiyoshi Takahara, Keitaro Tanaka, Masahiro Daimon, Hironori Kanehara, Toshiaki Suzuki, Yusaku Iwamoto, Motomu Tsuji, Haruhito Azuma, Junji Okuda, Takahiro Katsumata, Yoji Katsuoka

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)565-569
Number of pages5
JournalActa Urologica Japonica
Volume53
Issue number8
Publication statusPublished - 01-08-2007

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Fistula
Ureter
Stents
Aorta
Radiotherapy
Percutaneous Nephrostomy
Urinary Catheters
Seminoma
Abdominal Aorta
Hematuria
Pathologic Constriction
Lymph Nodes
Hemorrhage
Neoplasm Metastasis
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Segawa, N., Hamada, S., Takahara, K., Tanaka, K., Daimon, M., Kanehara, H., ... Katsuoka, Y. (2007). Ureteral-abdominal aortic fistula during the exchange of ureteral stenting: A case report. Acta Urologica Japonica, 53(8), 565-569.
Segawa, Naoki ; Hamada, Syuji ; Takahara, Kiyoshi ; Tanaka, Keitaro ; Daimon, Masahiro ; Kanehara, Hironori ; Suzuki, Toshiaki ; Iwamoto, Yusaku ; Tsuji, Motomu ; Azuma, Haruhito ; Okuda, Junji ; Katsumata, Takahiro ; Katsuoka, Yoji. / Ureteral-abdominal aortic fistula during the exchange of ureteral stenting : A case report. In: Acta Urologica Japonica. 2007 ; Vol. 53, No. 8. pp. 565-569.
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abstract = "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.",
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Segawa, N, Hamada, S, Takahara, K, Tanaka, K, Daimon, M, Kanehara, H, Suzuki, T, Iwamoto, Y, Tsuji, M, Azuma, H, Okuda, J, Katsumata, T & Katsuoka, Y 2007, 'Ureteral-abdominal aortic fistula during the exchange of ureteral stenting: A case report', Acta Urologica Japonica, vol. 53, no. 8, pp. 565-569.

Ureteral-abdominal aortic fistula during the exchange of ureteral stenting : A case report. / Segawa, Naoki; Hamada, Syuji; Takahara, Kiyoshi; Tanaka, Keitaro; Daimon, Masahiro; Kanehara, Hironori; Suzuki, Toshiaki; Iwamoto, Yusaku; Tsuji, Motomu; Azuma, Haruhito; Okuda, Junji; Katsumata, Takahiro; Katsuoka, Yoji.

In: Acta Urologica Japonica, Vol. 53, No. 8, 01.08.2007, p. 565-569.

Research output: Contribution to journalArticle

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

PY - 2007/8/1

Y1 - 2007/8/1

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.

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M3 - Article

VL - 53

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JF - Acta Urologica Japonica

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Segawa N, Hamada S, Takahara K, Tanaka K, Daimon M, Kanehara H et al. Ureteral-abdominal aortic fistula during the exchange of ureteral stenting: A case report. Acta Urologica Japonica. 2007 Aug 1;53(8):565-569.