Aortoureteric Fistula after Total Cystectomy Complicated with Multidrug-Resistant Pseudomonas Infection
10.4326/jjcvs.35.275
- VernacularTitle:多剤耐性緑膿菌感染を伴った膀胱全摘術後大動脈尿管瘻の１例
- Author:
Kenji Matsuzaki
;
Norihiko Shiiya
;
Tomoyoshi Yamashita
;
Takashi Kunihara
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2006;35(5):275-277
- CountryJapan
- Language:Japanese
-
Abstract:
A 77-year-old man, who had undergone total cystectomy, was transferred to our hospital because of repeated arterial bleeding from the left cutaneous urostomy on urostomy catheter exchange. Abdominal CT scan revealed infrarenal aortic and bilateral common iliac aneurysms. Multidrug-resistant Pseudomonas was detected from preoperative urine culture. A fistula between the left iliac artery and the left ureter was strongly suspected and an operation was performed. Aneurysmectomy and graft replacement with a bifurcated graft was conducted. Both limbs of the Y-graft were anastomosed to the right internal and external iliac artery. The left lower extremity was revascularized using femorofemoral bypass. After left nephrostomy, the graft was wrapped around with an omental flap. The postoperative course was uneventful, without infective complications.
