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Vascular and Endovascular Surgery
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Ureteral Perigraft Fistula

Samuel Deem, DO

Department of Surgery, West Virginia University-Charlston Division Charleston, samuel_deem{at}yahoo.com

Patrick Stone, MD

Department of Vascular Surgery, West Virginia University-Charlston Division Charleston

Chris Schlarb, MD

Department of Radiology, West Virginia UniversityCharlston Division Charleston

Ureteral injury following aortic surgery occurs in less than 1% of all cases. Ureteral-arterial fistulae rarely occur in the current literature and only in case reports. This case involves a suspected ureteral aortic graft fistula presenting with acute hematuria with distant history of redo aortic bifemoral graft for aortoenteric fistula. Cystoscopy with retrograde pyelogram was performed and demonstrated what appeared to be a fistula between the left ureter and the aortic graft with a proximal hydroureter and hydronephrosis. After a detailed review of the films, we diagnosed a more benign ureteral perigraft fistula. Multidisciplinary management including urology and vascular surgery suggested conservative management. However, the patient later required more definitive therapy for his illness. This case demonstrates a ureteral perigraft fistula and displays how it appears radiographically. Here we present our experience with this new radiological diagnosis.

Key Words: fistula • ureter • graft

Vascular and Endovascular Surgery, Vol. 41, No. 4, 352-354 (2007)
DOI: 10.1177/1538574407303175
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