[A case of uretero-aortic fistula after the urinary diversion]

Abstract

We report a case of a patient with a fistula between left ureter and abdominal aorta. The patient was a 84-year-old male who had undergone total cystectomy with a single stoma cutaneous ureterostomy for the treatment of transitional cell carcinoma of the bladder. His postoperative course was complicated by stenosis of the stomal orifices, which was treated with two silicone tubes. Twelve years after the operation, massive arterial bleeding occurred from the cutaneous ureterostomy, which was caused by left ureteral-abdominal aortic aneurysm fistula due to prolonged ureteral stenting. Graft replacement for abdominal aortic aneurysm and percutaneous left nephrostomy were performed, but he died 3 months following the operation due to multiple organ failure. Ureteroarterial fistula after the urinary diversion can occur in association with prolonged ureteral stenting, radiation therapy, and vascular pathology. Identification of a fistula is often difficult and requires the physician to be highly alert and vigilant.