A K Venyo1, S Shah. 1. North Manchester General Hospital, Department of Urology, Delaunays Road, Crumpsall, Manchester, M8 5RB, UK. akodzogrey@yahoo.co.uk
Abstract
BACKGROUND: Non traumatic fistula between a lower polar aberrant renal vein and renal pelvis is a very rare condition, which to our knowledge has not been previously reported in the English literature. OBJECTIVE: To report a rare case of non-traumatic fistula between an aberrant lower polar renal vein and renal pelvis. CASE REPORT: An 80-year old man presented with six-week history of intermittent haematuria. He was fully assessed clinically in addition to having an intervenous urography, ultrasonography, ureteropyelogram and selective right renal angiography and the venography which confirmed the presence of a fistula between the right renal pelvis and an aberrant tortuous lower polar right renal vein just above the level of the pelviureteric junction. There was no communication with an artery. The fistula was successfully treated by selective angiographic (venographic) embolization using a coil. Immediately after the emboliza-tion the haematuria settled. CONCLUSION: In our opinion renal veno-pelvis fistulae should be managed in the first place by selective angiography to confirm the diagnosis and then by embolization at the same sitting. If embolization fails, then surgical closure of the fistula may be achieved either through laparoscopic or open surgical approach and the vessel may be ligated or occluded.
BACKGROUND:Non traumatic fistula between a lower polar aberrant renal vein and renal pelvis is a very rare condition, which to our knowledge has not been previously reported in the English literature. OBJECTIVE: To report a rare case of non-traumatic fistula between an aberrant lower polar renal vein and renal pelvis. CASE REPORT: An 80-year old man presented with six-week history of intermittent haematuria. He was fully assessed clinically in addition to having an intervenous urography, ultrasonography, ureteropyelogram and selective right renal angiography and the venography which confirmed the presence of a fistula between the right renal pelvis and an aberrant tortuous lower polar right renal vein just above the level of the pelviureteric junction. There was no communication with an artery. The fistula was successfully treated by selective angiographic (venographic) embolization using a coil. Immediately after the emboliza-tion the haematuria settled. CONCLUSION: In our opinion renal veno-pelvis fistulae should be managed in the first place by selective angiography to confirm the diagnosis and then by embolization at the same sitting. If embolization fails, then surgical closure of the fistula may be achieved either through laparoscopic or open surgical approach and the vessel may be ligated or occluded.