INTRODUCTION: Primary arterial-ureteral fistula is a rare and diagnostically challenging condition which may present with massive hematuria. PRESENTATION OF CASE: A case of primary arterial-ureteral fistula (AUF) is presented in a patient with a previous prosthetic aortic-bifemoral bypass. The AUF treated with arterial and ureteral resection, arterial ligation and ureteral reconstruction. DISCUSSION: Primary AUF are more frequently associated with aneurysmal degeneration of the arterial wall. The development of a primary fistula due to an iliac artery aneurysm many years after an aortic-bifemoral bypass performed due to atherosclerotic obstructive disease is a very unusual presentation of this entity. Multiple surgical strategies can be employed in achieving hemorrhage and infection control, urinary tract continuity, and vascular reconstruction. CONCLUSION: A multidisciplinary approach and the achievement of a pre-operative diagnosis are essential for an effective management of this condition with prognostic implications.
INTRODUCTION: Primary arterial-ureteral fistula is a rare and diagnostically challenging condition which may present with massive hematuria. PRESENTATION OF CASE: A case of primary arterial-ureteral fistula (AUF) is presented in a patient with a previous prosthetic aortic-bifemoral bypass. The AUF treated with arterial and ureteral resection, arterial ligation and ureteral reconstruction. DISCUSSION: Primary AUF are more frequently associated with aneurysmal degeneration of the arterial wall. The development of a primary fistula due to an iliac artery aneurysm many years after an aortic-bifemoral bypass performed due to atherosclerotic obstructive disease is a very unusual presentation of this entity. Multiple surgical strategies can be employed in achieving hemorrhage and infection control, urinary tract continuity, and vascular reconstruction. CONCLUSION: A multidisciplinary approach and the achievement of a pre-operative diagnosis are essential for an effective management of this condition with prognostic implications.
Authors: David C Madoff; Sanjay Gupta; Barry D Toombs; Mark D Skolkin; Chusilp Charnsangavej; Frank A Morello; Kamran Ahrar; Marshall E Hicks Journal: AJR Am J Roentgenol Date: 2004-05 Impact factor: 3.959
Authors: Roderick C N van den Bergh; Frans L Moll; Jean-Paul P M de Vries; Kakkhee K Yeung; Tycho M T W Lock Journal: J Urol Date: 2007-12-21 Impact factor: 7.450
Authors: Rafael D Malgor; Gustavo S Oderich; James C Andrews; Michael McKusick; Manju Kalra; Sanjay Misra; Peter Gloviczki; Thomas C Bower Journal: J Vasc Surg Date: 2012-02-10 Impact factor: 4.268