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Ureterocolic fistula secondary to a self-expanding retrievable ureteral stent.

Ransford G, Pan D, Eldefrawy A, Narayanan G, Manoharan M - Cent European J Urol (2013)

Bottom Line: Self-expanding stents are relatively new in the field of urology and have primarily been used for permanent remodeling of benign or malignant stricture.We are presenting a rare and interesting case of a ureterocolic fistula that formed secondary to placement of an expandable, retrievable metal stent in the ureter.The patient chose to manage it non-surgically, with routine nephroureteral catheter exchanges, and her creatinine continues to remain stable.

View Article: PubMed Central - PubMed

Affiliation: University of Miami Miller School of Medicine, Miami, FL, USA.

ABSTRACT
Self-expanding stents are relatively new in the field of urology and have primarily been used for permanent remodeling of benign or malignant stricture. We are presenting a rare and interesting case of a ureterocolic fistula that formed secondary to placement of an expandable, retrievable metal stent in the ureter. After multiple retrieval efforts, the self-expanding metal stent was finally retrieved and a ureterocolic fistula was appreciated on antegrade pyelography. The patient chose to manage it non-surgically, with routine nephroureteral catheter exchanges, and her creatinine continues to remain stable.

No MeSH data available.


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Retrievable stent removed, enterocolic fistula visualized.
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Figure 0002: Retrievable stent removed, enterocolic fistula visualized.

Mentions: In a post–operative follow–up appointment, the patient complained of right flank pain and discomfort, as well as malodorous urine – very common symptoms of a ureterocolic fistula [7]. An antegrade pyelogram demonstrated a fistulous connection between the ureter and the sigmoid colon (Figure 2). In consultation with the colorectal team, we recommended an exploratory laparotomy, lysis of adhesions, and repair of the fistulous connection. However, the patient declined active treatment and elected to continue having routine nephroureteral catheter exchanges. Over the next eight months, she continued to have urinary tract infections, but no fecaluria or pneumaturia. Her most recent creatinine, six months ago, was 0.67 mg/dl, and she continues to have an E. coli positive urine culture. On her most recent visit two months ago, the nephroureteral catheter was exchanged for a double–J stent. During that exchange, a retrograde pyelogram was performed but no fistula could be appreciated.


Ureterocolic fistula secondary to a self-expanding retrievable ureteral stent.

Ransford G, Pan D, Eldefrawy A, Narayanan G, Manoharan M - Cent European J Urol (2013)

Retrievable stent removed, enterocolic fistula visualized.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3936141&req=5

Figure 0002: Retrievable stent removed, enterocolic fistula visualized.
Mentions: In a post–operative follow–up appointment, the patient complained of right flank pain and discomfort, as well as malodorous urine – very common symptoms of a ureterocolic fistula [7]. An antegrade pyelogram demonstrated a fistulous connection between the ureter and the sigmoid colon (Figure 2). In consultation with the colorectal team, we recommended an exploratory laparotomy, lysis of adhesions, and repair of the fistulous connection. However, the patient declined active treatment and elected to continue having routine nephroureteral catheter exchanges. Over the next eight months, she continued to have urinary tract infections, but no fecaluria or pneumaturia. Her most recent creatinine, six months ago, was 0.67 mg/dl, and she continues to have an E. coli positive urine culture. On her most recent visit two months ago, the nephroureteral catheter was exchanged for a double–J stent. During that exchange, a retrograde pyelogram was performed but no fistula could be appreciated.

Bottom Line: Self-expanding stents are relatively new in the field of urology and have primarily been used for permanent remodeling of benign or malignant stricture.We are presenting a rare and interesting case of a ureterocolic fistula that formed secondary to placement of an expandable, retrievable metal stent in the ureter.The patient chose to manage it non-surgically, with routine nephroureteral catheter exchanges, and her creatinine continues to remain stable.

View Article: PubMed Central - PubMed

Affiliation: University of Miami Miller School of Medicine, Miami, FL, USA.

ABSTRACT
Self-expanding stents are relatively new in the field of urology and have primarily been used for permanent remodeling of benign or malignant stricture. We are presenting a rare and interesting case of a ureterocolic fistula that formed secondary to placement of an expandable, retrievable metal stent in the ureter. After multiple retrieval efforts, the self-expanding metal stent was finally retrieved and a ureterocolic fistula was appreciated on antegrade pyelography. The patient chose to manage it non-surgically, with routine nephroureteral catheter exchanges, and her creatinine continues to remain stable.

No MeSH data available.


Related in: MedlinePlus