Abstract
A 57-year-old man had undergone a total pelvic exenteration with an ileal conduit followed by ureteral stenting for the treatment of advanced rectal cancer. One month after the operation, gross hematuria occurred from the ileal conduit. An arteriography showed a connection between the left external iliac artery and the ureter, suggesting an ureteroarterial fistula. The patient was received endovascular treatment using an intraarterial covered stent-graft through the left external iliac artery. The hematuria disappeared after the endovascular correction of the ureteroarterial fistula. However, a persistent infection of the intraarterial stent graft was recognized thereafter. Therefore, femorofemoral crossover arterial bypass surgery with en bloc resection of the ureteroarterial fistula was performed. The postoperative course was uneventful, and the patient was discharged two months after the bypass surgery. Ureteroarterial fistula following urinary diversion can occur in association with the prolonged insertion of a ureteral stent ; thus, caution regarding the possible development of a ureteroarterial fistula is necessary in cases with the prolonged insertion of ureteral stents for ileal conduit.
