An unusual cause of haematuria - case report

Authors

  • João Peixoto Serviço de Angiologia e Cirurgia Vascular; Centro Hospitalar Vila Nova de Gaia/Espinho; Departamento De Cirurgia E Fisiologia Da Faculdade De Medicina Da Universidade Do Porto, Portugal https://orcid.org/0000-0002-3114-1047
  • Pedro Brandão Serviço de Angiologia e Cirurgia Vascular; Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
  • Carolina Semião Serviço de Angiologia e Cirurgia Vascular; Centro Hospitalar Vila Nova de Gaia/Espinho; Departamento De Cirurgia E Fisiologia Da Faculdade De Medicina Da Universidade Do Porto, Portugal https://orcid.org/0000-0002-4841-8719
  • Luis Fernandes Serviço de Angiologia e Cirurgia Vascular; Centro Hospitalar Vila Nova de Gaia/Espinho; Departamento De Cirurgia E Fisiologia Da Faculdade De Medicina Da Universidade Do Porto, Portugal
  • Alexandra Canedo Serviço de Angiologia e Cirurgia Vascular; Centro Hospitalar Vila Nova de Gaia/Espinho; Departamento De Cirurgia E Fisiologia Da Faculdade De Medicina Da Universidade Do Porto, Portugal https://orcid.org/0000-0002-4672-4034

DOI:

https://doi.org/10.48750/acv.512

Keywords:

uretero-arterial fistula, haematuria, uretero-iliac fistula

Abstract

INTRODUCTION: The development of a uretero-arterial fistula (UAF) is a rare and life-threatening condition. Owing to its low prevalence, diagnosis and management remains a challenge for both urologists and vascular surgeons and UAF’s high mortality rates may be at least partially attributed to delayed diagnosis. We present a case of UAF in a patient with previous pelvic surgery and indwelling ureter catheter.

CASE REPORT: An 82-year-old male presented to the emergency department with haemodynamic instability and gross haematuria that started one hour prior to admission. The laboratory study performed showed an acute anaemia of 7.5g/dl and a contrast enhanced computed tomography revealed a ureteral fistula betweenthe stented left ureter and the common iliac artery. The patient was taken to the angiography suit and a balloon- expandable stent-graft (GORE® VIABAHN® VBX – 11mm diameter and 59mm in length) was deployed.

Following the procedure, the haematuria resolved, and the patient had an uneventful post-operative stay. He was discharged two weeks after admission, following a course of large spectrum antibiotic therapy. The patient remained asymptomatic at 3 month follow up.

CONCLUSIONS: Uretero-arterial fistula is an uncommon condition but with an increasing prevalence, at least in part due to improved pelvic cancer treatment.

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References

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Published

2023-08-15

How to Cite

1.
Peixoto J, Brandão P, Semião C, Fernandes L, Canedo A. An unusual cause of haematuria - case report. Angiol Cir Vasc [Internet]. 2023 Aug. 15 [cited 2024 Jun. 21];19(2):51-3. Available from: https://acvjournal.com/index.php/acv/article/view/512

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Section

Clinical Case