BACKGROUND: Calyceal fistulas are common and difficult to treat after surgery of urinary collecting system. METHODS: A 30-year old woman. The fifth day after receiving a cadaver donor renal allograft presented an acute rejection episode; fourteen days later presented an urinoma treated with a percutaneous drainage tube. Five days later surgical exploration was made, lower pole infarction and ischemic necrosis of distal ureter were found. Parcial nephrectomy and neo-ureterovesical anastomosis were performed. Later, an inferior calyceal fistula was evidenced, persisting during several weeks in spite of a percutaneous drainage tube. Under fluoroscopic guidance the fistulous tract was embolized with N-butyl-2-cyanoacrylate. RESULTS: The fluoroscopic control confirmed the total closure of the fistula. After 22 months no reappearance of the fistula, no stenosis has been shown at this level. CONCLUSIONS: This is a useful technique for the treatment of calyceal fistulas. This is the first time that N-butyl-2-cyanoacrylate is use in the treatment of a calyceal fistula.
BACKGROUND:Calyceal fistulas are common and difficult to treat after surgery of urinary collecting system. METHODS: A 30-year old woman. The fifth day after receiving a cadaver donor renal allograft presented an acute rejection episode; fourteen days later presented an urinoma treated with a percutaneous drainage tube. Five days later surgical exploration was made, lower pole infarction and ischemic necrosis of distal ureter were found. Parcial nephrectomy and neo-ureterovesical anastomosis were performed. Later, an inferior calyceal fistula was evidenced, persisting during several weeks in spite of a percutaneous drainage tube. Under fluoroscopic guidance the fistulous tract was embolized with N-butyl-2-cyanoacrylate. RESULTS: The fluoroscopic control confirmed the total closure of the fistula. After 22 months no reappearance of the fistula, no stenosis has been shown at this level. CONCLUSIONS: This is a useful technique for the treatment of calyceal fistulas. This is the first time that N-butyl-2-cyanoacrylate is use in the treatment of a calyceal fistula.
Authors: Gabriela Ambriz-González; Pedro Aguirre-Ramirez; José Manuel García-de León; Francisco Javier León-Frutos; Sergio Adrián Montero-Cruz; Xóchitl Trujillo; Clotilde Fuentes-Orozco; Michel Dassaejv Macías-Amezcua; Andrea del Socorro Álvarez-Villaseñor; Ana Olivia Cortés-Flores; Mariana Chávez-Tostado; Alejandro González-Ojeda Journal: BMC Urol Date: 2014-11-21 Impact factor: 2.264