URETERO-ARTERIAL FISTULA - 2 OBSERVATIONS

Two cases of life-threatening haematuria, secondary to an uretero-arte rial fistula, are reported. Both cases present predisposing causative factors. One patient had a combination of previous aorto-bifemoral byp ass grafting, an iliac artery aneurysm (retrogradely perfused), and an indwelling ureteral stent for ureteral compression. The other patient had previous aortoiliac surgery and obstructive uropathy with chronic urinary tract infection. Preoperative diagnosis of uretero-arterial f istula was made in only one patient. He was successfully operated (exc lusion of the iliac aneurysm). In the other patient, nephrectomy was a ttempted to control reno-ureteral bleeding of unknown origin. Fatal re cidive of brisk haematuria occurred some days later. Factors contribut ing to the development of uretero-arterial fistula, their diagnosis an d optimal treatment are discussed.