1/403. Disseminated herpes simplex virus infection in a renal transplant patient as possible cause of repeated urinary extravasations. Disseminated herpes simplex virus type 2 (HSV-2) infections are infrequent in patients receiving organ transplants, but usually have a poor outcome. We describe the case of a renal transplant patient who developed a disseminated HSV-2 infection with repeated urinary extravasations. The diagnosis was carried out using a multiplex polymerase chain reaction nested assay and it suggested HSV-2 as a possible cause of repeated urinary fistulas. ( info) |
2/403. Pyloric atresia associated with epidermolysis bullosa, malrotation, and high anorectal malformation with recto-urethral fistula: a report of successful management. Pyloric atresia (PA) is an uncommon anomaly that may be associated with many other congenital anomalies, the commonest of which is junctional epidermolysis bullosa (JEB). Most of the cases of PA associated with JEB (Herlitz syndrome) reported have been fatal. A case of PA associated with JEB, malrotation, and a high anorectal malformation with a rectourethral fistula, which was hitherto undescribed, was successfully managed at our institution. ( info) |
3/403. Iatrogenic reno-jejunal fistula. The development of a reno-jejunal fistula following a Roux-en-Y cystojejunostomy for an incorrectly diagnosed pancreatic pseudocyst is described. Up to now, this is the second case of iatrogenic reno-jejunal fistula reported in literature. Reno-jejunal fistulas are exceedingly rare and are usually consequences of urologic pathologies of infectious origin. Reno-jejunal fistulas of iatrogenic origin are even rarer, only one case being referred in literature [1]. Herein the second case is reported. ( info) |
4/403. Our surgical approach towards the treatment of urethrocele and urethral fistula. A new technique, described in the text, has been elaborated inspired by that of Monseur (1968) for urethral techniques. It has been performed with success in three paraplegics and in one incomplete tetraparesis. The plastic reconstruction of the diseased part of the urethra after excision of the stenosis and a fistula or diverticula by rotation and fixation to the subcavernal groove creates, in fact, an enlarged neo-urethra rendering the recurrence of the primary lesion practically impossible. This technique, first applied to spinal cord injuries, has been extended with permanent success to other lesions, such as tuberculosis stenosis and malformations. ( info) |
5/403. Vesicocolonic fistula four years after augmentation colocystoplasty. An 8-year-old girl was born with crossed fused renal ectopia and neurogenic bladder due to sacral agenesis. Due to progressive upper tract deterioration and incontinence despite clean intermittent catheterization and pharmacotherapy with anticholinergic agents, the patient underwent augmentation colocystoplasty at the age of 4 years. Four years after surgery the girl was readmitted because of persistent febrile urinary tract infection, persistent metabolic acidosis, and intermittent watery diarrhea. A cystogram revealed a fistula between the dome of the augmented bladder and the transverse colon. The fistula was successfully resected. The presence of enterovesical fistula should always be suspected in a patient with augmented bladder who have late onset of urinary tract infection, metabolic acidosis, and diarrhea. ( info) |
6/403. Endovascular stent graft for management of ureteroarterial fistula after orthotopic bladder substitution. We describe the first case of an ureteroarterial fistula developing after orthotopic neobladder substitution and its minimally invasive management using endovascular stent grafting. We outline the risk factors for the development of ureteroarterial fistulae and trace the evolution of diagnostic and therapeutic modalities used in the management of these life-threatening complications. Minimally invasive management with endovascular stent grafting and exclusion of two pseudoaneurysms in the iliac artery system was performed successfully. After successful endovascular exclusion of two pseudoaneurysms, the patient's hematuria resolved and he recovered fully. Three-dimensional computed tomography performed 3 months later documented a patent aortoiliac arterial system without evidence of pseudoaneurysm or endovascular leak. Ureteroarterial fistula after orthotopic bladder substitution was managed with an endovascular stent graft without the need for extra-anatomical vascular bypass. Early recognition, stabilization, and angiographic evaluation followed by this minimally invasive technique may avoid open operative repair and attendant morbidity. ( info) |
7/403. Nephrobronchial fistula secondary to xantogranulomatous pyelonephritis. We report a case of staghorn nephrolithiasis that evolved into xanthogranulomatous pyelonephritis with perinephric abscess, nephrobronchial fistula, and lung abscess. The patient was an intravenous drug abuser who tested positive for human immunodeficiency virus, without evidence of acquired immunodeficiency syndrome. He presented with a 2-month history of untreated repeated episodes of left flank pain and hyperpyrexia. Treatment involved left nephrectomy, debridement of abscess, tube drainage, and intravenous antibiotics. The patient illustrates the need to consider untreated nephrolitiasis as a predisposing factor for pulmonary complications. ( info) |
8/403. Endovascular management of ureteroarterial fistula. Ureteroarterial fistulas, although rare, appear to be increasing in frequency. Because open surgical repair may be difficult and associated with significant risk for complications, endovascular intervention may provide an attractive treatment alternative. We review the diagnosis and management of a ureteroarterial fistula and iliac pseudoaneurysm that presented with massive hematuria during ureteral stent removal. The patient was treated by means of the percutaneous embolization of the right hypogastric artery and placement of an expanded polytetrafluoroethylene stent-graft. Endovascular stent-graft placement may serve as a safe and practical alternative in the treatment of these patients, whose cases are challenging. ( info) |
9/403. Congenital urethral fistula. A 3-year-old male child was presented with the history of passage of urine coming from the undersurface of penis and its tip since birth. An opening was present on the ventral aspect of midshaft of penis through which a catheter could be passed. It was diagnosed as urethral fistula which was managed surgically. ( info) |
10/403. Congenital urethral fistula. A case of congenital urethral fistula with an intact glanular urethra without chordee is reported with a discussion of the possible etiology and one-stage repair. ( info) |