Ureteroduodenal Fistula

Abstract

A 7 3-year-old man presented with pain in the right flank and fever. A ureteroduodenal fistula was demonstrated by intravenous pyelography and excised with nephroureterectomy. This seems to be the 8th case of such a lesion.

Spontaneous pyelo-jejunal fistula

“…When the ureter is occluded the fistula may not be shown even if the examination is a technical success. 18 Antegrade pyelography has been used many times in recent years to confirm a suspected nephrointestinal fistula and is now the investigation of choice in this context. The technique is described along with the indications, contra-indications and complications in papers by Jeans'9 and Pfister and Newhouse.20 The infective complications may be significantly reduced by prophylactic antibiotics.21 The success of antegrade pyelography in the diagnosis of urinary-intestinal fistulae has been ascribed to the injection of contrast under controlled pressure.2 This probably also accounts for the relative success of sinography and retrograde pyelography where contrast is also injected under similar conditions of controlled pressure.…”

Uretero‐enteric fistula

“…Urinary, gastrointestinal and constitutional symptoms are the usual manifestation in patients with such fistulae. Flank pain is the most common symptom, together with fever, pyuria or haematuria [ 1, 2]. The diagnosis depends on radiological studies, with retrograde pyelography the most effective method.…”

“…The diagnosis depends on radiological studies, with retrograde pyelography the most effective method. Nephro‐ureterectomy with the closure of the intestinal fistula is the most common treatment described [ 1] but the choice of surgery, endoscopic or open, depends on the symptoms, signs, level and extent of injury. We recommend ureteric stenting as an alternative in managing uretero‐enteric fistulae in selected patients with no toxic signs.…”

“…Uretero‐enteric fistulae are rare; most cases have involved the right upper or middle ureter, with left‐sided fistulae extremely rare [ 1–3]. The causes have varied, the most common being a urological origin [ 1].…”

“…Uretero‐enteric fistulae are rare; most cases have involved the right upper or middle ureter, with left‐sided fistulae extremely rare [ 1–3]. The causes have varied, the most common being a urological origin [ 1]. A recent study showed a significant increase in the incidence of ureteric injury caused by the increasing use of ureteroscopic and laparoscopic surgery [ 4].…”