Meecham L, Koo V, Rajjayabun Ph
Alexandra Hospital, Redditch, UK.
J Surg Case Rep. 2012 Aug 1;2012(8):16. doi: 10.1093/jscr/2012.8.16.
Visible haematuria from an uretero-iliac artery aneurysm fistula (UIAF) offers a diagnostic challenge and early accurate diagnosis can have a significant impact on prognosis. We report a 90 year old gentleman who presented with visible haematuria and clot retention. He required catheterisation, bladder washout and a blood transfusion. Subsequent imaging revealed an abdominal aortic aneurysm and bilateral iliac artery aneurysms with left sided hydronephrosis and hydroureter. There was no radiological evidence of a fistula between the left ureter and iliac aneurysm. Due to associated co-morbidity surgical intervention was not deemed suitable. Although his haematuria initially settled he developed catastrophic haematuria and died. Post-mortem confirmed UIAF causing fatal haemorrhage. In this report we discuss the diagnostic challenges and management options for this condition.
输尿管-髂动脉瘤瘘（UIAF）导致的肉眼血尿带来了诊断难题，早期准确诊断对预后有重大影响。我们报告一例90岁男性患者，表现为肉眼血尿和血块潴留。他需要进行导尿、膀胱冲洗和输血。随后的影像学检查显示腹主动脉瘤和双侧髂动脉瘤，伴有左侧肾积水和输尿管积水。没有放射学证据表明左输尿管与髂动脉瘤之间存在瘘管。由于存在相关合并症，手术干预被认为不合适。尽管他的血尿最初得到缓解，但后来出现了灾难性血尿并死亡。尸检证实UIAF导致致命性出血。在本报告中，我们讨论了这种疾病的诊断挑战和治疗选择。
