Successful transcatheter arterial embolization for uretero-inferior epigastric arterial fistula: A rare complication of cutaneous ureterostomy

• Published in: Urology case reports 2021-09, Vol.38, p.101726, Article 101726
• Main Authors: Nakama, Rakuhei, Arai, Yasunori, Takei, Yohei, Kobayashi, Tatsushi
• Format: Article
• Language: English
• Subjects: Cutaneous ureterostomy; Inferior epigastric artery; Oncology; Transcatheter arterial embolization; Uretero-arterial fistula
• ISSN: 2214-4420; 2214-4420
• DOI: 10.1016/j.eucr.2021.101726

A 70-year-old man presented with pulsatile bleeding upon changing his catheter for cutaneous ureterostomy. He was suspected to have a uretero-arterial fistula. Computed tomography showed an abnormally dilated right inferior epigastric artery, the suspected bleeding source. Angiography revealed a tortuous dilated branch from the inferior epigastric artery. Transcatheter arterial embolization was performed with a gelatin sponge and coil. He was discharged 15 days after the procedure. Uretero-arterial fistula is a rare but fatal complication among patients with long-term indwelling ureter catheters. An abnormal inferior epigastric artery surrounding the cutaneous ureterostomy should be considered a rare cause of uretero-arterial fistula. •UAF is a rare but fatal complication in patients with indwelling ureter catheters.•Delays in the diagnosis of UAF have caused poor outcomes.•The aorta, and iliac and inferior epigastric arteries may cause UAF.•The source of bleeding should be immediately identified using CT or angiography.•Physicians should be aware of the rare causes of UAF.