Huh Jung Sik, Park Kyung Kgi
Department of Urology, School of Medicine, Jeju National University, Jeju, South Korea.
Urol Case Rep. 2025 Aug 13;62:103162. doi: 10.1016/j.eucr.2025.103162. eCollection 2025 Sep.
A 56-year-old female experienced massive pulsatile bleeding from the left ureter during routine ureteral stent exchange. She had a history of radical cystectomy and bilateral stent insertion due to uretero-intestinal strictures. Upon stent removal, sudden bleeding through the urostomy led to hypovolemic shock. Urostomy site compression stabilized the patient, and CT revealed suspected ureteroarterial fistula. Angiography confirmed the diagnosis. Covered stent placement in the external iliac artery resolved the condition. No recurrence was observed during a three-year follow-up. Prompt tamponade followed by endovascular intervention can be life-saving in such cases.
一名56岁女性在进行常规输尿管支架置换时，左侧输尿管出现大量搏动性出血。她有根治性膀胱切除术和因输尿管肠道狭窄而双侧置入支架的病史。取出支架后，经造口突然出血导致低血容量性休克。造口部位压迫使患者病情稳定，CT显示疑似输尿管动脉瘘。血管造影确诊了该诊断。在髂外动脉置入覆膜支架解决了该问题。三年随访期间未观察到复发。在这种情况下，迅速压迫止血后进行血管内介入治疗可挽救生命。
