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一例根治性膀胱切除术后输尿管髂骨瘘的多学科病例。

A multidisciplinary case of ureteroiliac fistula after radical cystectomy.

作者信息

Rosales Morales Ricardo, Rigberg David A

机构信息

David Geffen School of Medicine, Los Angeles, Calif.

Division of Vascular Surgery, University of California, Los Angeles, Calif.

出版信息

J Vasc Surg Cases Innov Tech. 2021 Dec 23;8(1):53-56. doi: 10.1016/j.jvscit.2021.11.007. eCollection 2022 Mar.

Abstract

Ureteroiliac fistula is a rare complication associated with ureteral stenting and iliac artery reconstruction and can lead to life-threatening hemorrhage. We report a case of acute bleeding from a ureteroiliac fistula in an 89-year-old man with bladder cancer who had undergone pelvic radiation, radical cystectomy, and ileal conduit complicated by ureteral strictures requiring routine stent exchanges. Multidisciplinary diagnostic therapies revealed the fistula, which was treated with hypogastric artery coiling and covered stent placement. No further bleeding issues had resulted from the fistula at 11 months of follow-up. The presence of a ureteroiliac fistula should be considered in any patient with a similar history.

摘要

输尿管髂动脉瘘是一种与输尿管支架置入和髂动脉重建相关的罕见并发症,可导致危及生命的出血。我们报告一例89岁膀胱癌男性患者发生输尿管髂动脉瘘急性出血的病例,该患者曾接受盆腔放疗、根治性膀胱切除术及回肠代膀胱术,并发输尿管狭窄,需要定期更换支架。多学科诊断性治疗发现了瘘管,采用了髂内动脉栓塞和覆膜支架置入术进行治疗。随访11个月,瘘管未再引发出血问题。对于有类似病史的任何患者,均应考虑输尿管髂动脉瘘的存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/8783110/6113675681b6/gr1.jpg

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