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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Jaha, Luan Ismaili-Jaha, Vlora Ademi, Bekim Veselaj, Fahredin Kryeziu, Destan Gjikolli, Bujar Gecaj-Gashi, Agreta Koshi, Adhurim Jaha, Art |
| Abstract | Introduction Gross hematuria caused by rupture of an artery in the urinary tract is a rare but potentially fatal condition. Iliac artery aneurysms, pelvic surgery with radiation, vascular reconstructive surgery, surgery for stenosis of the ureteropelvic junction, and transplantation are reported to be associated with this condition. In the vascular reconstructive surgery group, the most common etiology is rupture of the degenerated artery or synthetic graft in the ureter. Case presentation We present a case of rupture of the small anastomotic pseudoaneurysm at the proximal anastomosis of a right iliofemoral autogenous vein extra-anatomic graft in the urinary bladder. To our knowledge, this is the first report of a rupture of an autogenous vein graft in the urinary bladder. Our patient, a 24-year-old Albanian farmer, was admitted to the emergency department in severe hemorrhagic shock induced by exsanguinating hematuria. He underwent immediate surgery, during which direct sutures to the bladder were placed and the saphenous graft was replaced with a synthetic one. The patient recovered completely, was free of hematuria, and showed no signs of pathological communication between the urinary and arterial tracts on postoperative cystoscopy and computed tomographic angiography during 2 years of follow-up. Conclusion The incidence of artery-to-urinary tract fistulas is growing due to the increasing use of urologic and vascular surgery, pelvic oncologic surgery, and radiation therapy. In addition to fistulas involving a degenerated artery and ureter or synthetic grafts and ureter, they can also involve an autogenous vein graft and the urinary bladder. In our patient, the fistula was a result of erosion of the bladder from a pseudoaneurysm at the proximal anastomosis of an autogenous vein iliofemoral bypass in an extra-anatomic position. Open surgery remains the best treatment option, although there is increasing evidence of successful endovascular treatment. |
| Related Links | https://jmedicalcasereports.biomedcentral.com/counter/pdf/10.1186/s13256-019-2300-8.pdf |
| Ending Page | 6 |
| Page Count | 6 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17521947 |
| DOI | 10.1186/s13256-019-2300-8 |
| Journal | Journal of Medical Case Reports |
| Issue Number | 1 |
| Volume Number | 13 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2019-12-08 |
| Access Restriction | Open |
| Subject Keyword | Medicine Public Health General Practice Family Medicine Primary Care Medicine Surgical Oncology Internal Medicine Massive hematuria Autogenous vein graft to urinary bladder fistula Extra-anatomic bypass Medicine/Public Health |
| Content Type | Text |
| Resource Type | Case study |
| Subject | Medicine |
| Journal Impact Factor | 0.9/2023 |
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