Case ‒ Uretero-internal iliac artery fistula presenting with multiple negative angiographic studies

  • Gautamn Sarwal Division of Vascular Surgery University of British Columbia
  • Samir Bidnur University of British Columbia
  • Edmund C.P. Chedgy University of British Columbia
  • Alex Kavanagh University of British Columbia

Abstract

We report a rare case of a patient presenting with visible, unexplained hematuria and share the diagnostic challenges faced in the setting of multiple angiographic studies that failed to demonstrate an uretero-internal iliac artery fistula. Uretero-arterial fistulas (UAF) are rare, but well-recognized, with increasingly common risk factors (Table 1).1 Due to its rarity, delay to diagnosis is common, when investigating recurrent hematuria with multiple negative investigations.1,2

Author Biographies

Gautamn Sarwal, Division of Vascular Surgery University of British Columbia

PGY-II Resident

Vascular & EndoVascular Surgery

University of British Columbia

Samir Bidnur, University of British Columbia

PGY-IV Resident

Department of Urological Sciences

University of British Columbia

Edmund C.P. Chedgy, University of British Columbia

Urologic Oncology Fellow

Department of Urological Sciences

University of British Columbia

Alex Kavanagh, University of British Columbia

Clinical Assistant Professor

Department of Urological Sciences

Vancouver General Hospital

Vancouver, BC

References

Rao AM, Khalil A, Suttie S. A rare cause of massive hematuria: Internal iliac artery-ureteric fistula. Vascular 2015; 23(2):193-196.

Van der Bergh RCN, Moll FL, de Vries JP, Lock TMTW. Arterioureteral fistulas: unusual suspects – systematic review of 139 cases. J Urol 2009; 74:251-255.

Darcy M. Uretro-arterial fistulas. Vasc Intervent Radiol 2009; 12:216-221.

Aslam MZ, Kheradmund F, Patel N, Cranston D. Uretero-iliac artery fistula: a diagnostic and therapeutic challenge. Adv Urol 2010.

Krambeck AE, DiMarco DS, Gettman MT, Segura JW. Ureteroiliac artery fistula: diagnosis and treatment algorithm. Urology 2005; 66(5):990-994.

Mitterberger M, Frauscher F, Steppan I, Peschel R, et al. Ureteroiliac fistula: a case report review of the literature. Cases Journal 2009; 2:6266.

Malgor RD, Oderich GS, Andrews JC, McKusick M, et al. Evolution from open surgical to endovascular treatment of ureteral-iliac artery fistula. J Vasc Surg 2012; 55:1072-80.

Muraoka N, Sakai T, Kimura H, et al. Endovascular treatment for an iliac artery-ureteral fistula with a covered stent. J Vasc Interven Radiol 2006; 17(10):1681-1685.

Bilbao JI, Cosin O, Bastarrika G, Rosell D, et al. Treatment of ureteroarterial fistulae with covered vascular endoprostheses and ureteral occlusion. Cardiovasc Intervent Radiol 2005; 28(2):159-163.

Hirsch LM, Amirian MJ, Hubosky SG et al. Urologic and endovascular repair of a uretero-iliac artery fistula. Cdn J Urol 2015; 22(1):7661-5.

Published
2018-02-02
How to Cite
Sarwal, G., Bidnur, S., Chedgy, E. C., & Kavanagh, A. (2018). Case ‒ Uretero-internal iliac artery fistula presenting with multiple negative angiographic studies. Canadian Urological Association Journal, 12(5), E250-2. https://doi.org/10.5489/cuaj.4758
Section
Residents' Room