S2293 Iliac Artery-Ureter-Colonic Fistula: An Unusual Cause of Gastrointestinal Hemorrhage and Hematuria

Harmouch, Farah; Shah, Kashyap; Liaquat, Hammad; Geme, Berhanu

doi:10.14309/01.ajg.0000782704.83462.ec

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“…Fatal ureteral bleeding is rare among elderly individuals. Several kinds of pathophysiology cause fatal ureteral bleeding, such as arterial ruptures and fistulas with arteries [1]. Arterial injuries caused by cancers can cause critical bleeding from the kidneys, ureters, bladder, and prostate [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…The common iliac arterio-ureteral fistula is one of the most common fistulas as the ureters anteriorly cross the common iliac artery [6]. The inducing factor is ureteral stents used for stenosis or obstruction of the ureter caused by cancers or stones [1,7]. Long-term installation of ureteral stents can cause inflammation, causing ulcers on the wall [3,8].…”

Section: Introductionmentioning

confidence: 99%

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Fatal Bleeding From a Common Iliac Arterio-Ureteral Fistula in an Older Patient

Ohta¹,

Inoue²,

Sano³

2022

Cureus

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Fatal ureteral bleeding is rare among elderly individuals. One cause of bleeding can be a fistula between the arteries and urinary organs, such as a common iliac arterio-ureteral fistula. However, the clinical presentation of fistulas can vary. As microscopic hematuria can be an initial finding, detecting the fistula without gross hematuria may be difficult. Here, we report a case of microhematuria that progressed to massive hematuria caused by a common iliac arterio-ureteral fistula. The patient was an 86-year-old man with a chief complaint of cardiopulmonary arrest. He was resuscitated in the previous condition. He had microscopic hematuria. One month later, the patient underwent rehabilitation. He was in hemorrhagic shock with massive hematuria. Further investigation revealed a right common iliac arterio-ureteral fistula. This case demonstrates the importance of investigating anemia in the elderly, including anemia of urinary origin, despite it being rare.

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Section: Introductionmentioning

confidence: 99%