Abstract
BackgroundRupture of the ureter with extravasation resulting from an iliac aneurysm is extremely rare. Herein, we report a case of ureteric rupture with urinary extravasation secondary to an iliac aneurysm.Case presentationAn 80-year-old man was admitted to our hospital for sudden onset of severe abdominal pain. Contrast-enhanced computed tomography demonstrated a large left internal iliac aneurysm (6.5 cm in diameter) and a ureteric rupture with leakage of contrast media from the left ureter, indicating a spontaneous ureteral rupture. The patient was treated with placement of a ureteral double-J stent under endoscopic and X-ray fluoroscopic guidance and endovascular aortic repair. His postoperative course was uneventful and he was discharged on postoperative day 20. A computed tomography scan at 2 weeks after surgery showed no contrast extravasation from the ureter or end leak.ConclusionCombination treatment with ureteral and endovascular stenting is effective in avoiding aneurysmal rupture and the serious consequences of a ureteral rupture, which include a perinephric or retroperitoneal collection, abscess formation, subsequent urosepsis, and graft infection.
Highlights
Rupture of the ureter with extravasation resulting from an iliac aneurysm is extremely rare
Combination treatment with ureteral and endovascular stenting is effective in avoiding aneurysmal rupture and the serious consequences of a ureteral rupture, which include a perinephric or retroperitoneal collection, abscess formation, subsequent urosepsis, and graft infection
It is usually secondary to a downstream obstruction by urinary calculi, stricture, or extrinsic compression resulting from malignancies, retroperitoneal fibrosis, and so on [1, 2]
Summary
We presented a rare case of ureteral rupture due to the expansion of an iliac aneurysm. Combination therapy, with ureteral stenting and EVAR, is useful in avoiding an aneurysmal rupture and the hostile consequences of a urinoma. Funding The authors declare no financial or any other type of support. Availability of data and materials Data sharing is not applicable to this article, as no datasets were generated or analyzed during the current study. SK and TS supported in the writing of the manuscript. KK supervised the writing of the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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