[Calyceal fistula in a renal allograft treated with N-Butyl-2-cyanoacrylate].

BACKGROUND

Calyceal fistulas are common and difficult to treat after surgery of urinary collecting system.

METHODS

A 30-year old woman. The fifth day after receiving a cadaver donor renal allograft presented an acute rejection episode; fourteen days later presented an urinoma treated with a percutaneous drainage tube. Five days later surgical exploration was made, lower pole infarction and ischemic necrosis of distal ureter were found. Parcial nephrectomy and neo-ureterovesical anastomosis were performed. Later, an inferior calyceal fistula was evidenced, persisting during several weeks in spite of a percutaneous drainage tube. Under fluoroscopic guidance the fistulous tract was embolized with N-butyl-2-cyanoacrylate.

RESULTS

The fluoroscopic control confirmed the total closure of the fistula. After 22 months no reappearance of the fistula, no stenosis has been shown at this level.

CONCLUSIONS

This is a useful technique for the treatment of calyceal fistulas. This is the first time that N-butyl-2-cyanoacrylate is use in the treatment of a calyceal fistula.