Bullock A, Andriole G L, Neuman N, Sicard G
Department of Surgery, Washington University School of Medicine, St. Louis, MO.
J Vasc Surg. 1992 Feb;15(2):436-41.
A 57-year-old woman who had been treated with an indwelling ureteral stent for over a year was admitted with massive gross hematuria caused by a fistula between the left ureter and hypogastric artery. Despite intensive radiographic evaluation, the definitive diagnosis was made only at the time of surgical exploration. Because of radiation-induced retroperitoneal fibrosis, midureteral obstruction, and prior pelvic and abdominal surgery, primary ureteral repair was not possible, and renal autotransplantation was performed. This case illustrates the need to consider the diagnosis of ureteroarterial fistula in patients with massive hematuria who have chronic indwelling stents, and the feasibility of autotransplantation when primary ureteral repair is not feasible.
一名57岁女性因左侧输尿管与髂内动脉之间的瘘管导致大量肉眼血尿入院，她接受留置输尿管支架治疗已超过一年。尽管进行了全面的影像学评估，但直到手术探查时才做出明确诊断。由于放疗引起的腹膜后纤维化、输尿管中段梗阻以及既往盆腔和腹部手术史，无法进行原发性输尿管修复，因此实施了自体肾移植。该病例表明，对于有慢性留置支架且出现大量血尿的患者，需要考虑输尿管动脉瘘的诊断，并且当原发性输尿管修复不可行时，自体肾移植是可行的。
