Ureteroarterial fistula: case report and review of literature.

Abstract

A fistula developed between the left common iliac artery and the distal left ureter of an 83-year-old woman who had undergone aortofemoral bypass grafting many years previously and in whom a Double-J stent was in place for 3 weeks while she was awaiting extracorporeal shock wave lithotripsy. Exsanguinating hemorrhage into the urinary tract necessitated emergency nephrectomy and vascular repair. Although these measures were successful temporarily, the patient died 6 weeks later of repeat myocardial infarction and acute renal failure. The increasing frequency of ureteral stent use and of an operation on the iliac arteries is expected to increase the frequency of these potentially catastrophic fistulas.