Abstract
This report describes a case of direct ureteral injury sustained during retroperitoneal vascular surgery. The diagnosis was delayed and treatment was complicated by infection. To address the patient's problem initially and then to consolidate our impressions, a literature review was undertaken. The conclusions from this review suggest that direct ureteral injury during vascular surgery is rare but most common during redo surgery, is just as likely to be missed as discovered during surgery, and when missed may be so for months. The diagnostic delay is caused by a varied and often misleading presentation, and a ureteral contrast study is the ultimate diagnostic tool. In these delayed cases the typical ureteral treatment is a stented ureteroureterostomy or nephrectomy. In the present case the patient was otherwise healthy; therefore an aggressive attitude to renal salvage was taken. This is a unique case of ileal conduit replacement of the damaged ureter for this specific situation. Five years after repair, renal function is stable without infectious complications. The current literature would suggest that the vascular graft may be left undisturbed if the urine is sterile. If infection is present, graft removal appears the standard of care and was successful in the present case.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 180-186 |
| Number of pages | 7 |
| Journal | Annals of Vascular Surgery |
| Volume | 7 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 1 1993 |
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ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine
Cite this
Vascular Surgery-Associated Ureteral Injury : Zebras Do Exist. / Dalsing, Michael C.; Bihrle, Richard; Lalka, Stephen G.; Cikrit, Dolores F.; Sawchuk, Alan P.
In: Annals of Vascular Surgery, Vol. 7, No. 2, 01.01.1993, p. 180-186.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vascular Surgery-Associated Ureteral Injury
T2 - Zebras Do Exist
AU - Dalsing, Michael C.
AU - Bihrle, Richard
AU - Lalka, Stephen G.
AU - Cikrit, Dolores F.
AU - Sawchuk, Alan P.
PY - 1993/1/1
Y1 - 1993/1/1
N2 - This report describes a case of direct ureteral injury sustained during retroperitoneal vascular surgery. The diagnosis was delayed and treatment was complicated by infection. To address the patient's problem initially and then to consolidate our impressions, a literature review was undertaken. The conclusions from this review suggest that direct ureteral injury during vascular surgery is rare but most common during redo surgery, is just as likely to be missed as discovered during surgery, and when missed may be so for months. The diagnostic delay is caused by a varied and often misleading presentation, and a ureteral contrast study is the ultimate diagnostic tool. In these delayed cases the typical ureteral treatment is a stented ureteroureterostomy or nephrectomy. In the present case the patient was otherwise healthy; therefore an aggressive attitude to renal salvage was taken. This is a unique case of ileal conduit replacement of the damaged ureter for this specific situation. Five years after repair, renal function is stable without infectious complications. The current literature would suggest that the vascular graft may be left undisturbed if the urine is sterile. If infection is present, graft removal appears the standard of care and was successful in the present case.
AB - This report describes a case of direct ureteral injury sustained during retroperitoneal vascular surgery. The diagnosis was delayed and treatment was complicated by infection. To address the patient's problem initially and then to consolidate our impressions, a literature review was undertaken. The conclusions from this review suggest that direct ureteral injury during vascular surgery is rare but most common during redo surgery, is just as likely to be missed as discovered during surgery, and when missed may be so for months. The diagnostic delay is caused by a varied and often misleading presentation, and a ureteral contrast study is the ultimate diagnostic tool. In these delayed cases the typical ureteral treatment is a stented ureteroureterostomy or nephrectomy. In the present case the patient was otherwise healthy; therefore an aggressive attitude to renal salvage was taken. This is a unique case of ileal conduit replacement of the damaged ureter for this specific situation. Five years after repair, renal function is stable without infectious complications. The current literature would suggest that the vascular graft may be left undisturbed if the urine is sterile. If infection is present, graft removal appears the standard of care and was successful in the present case.
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UR - http://www.scopus.com/inward/citedby.url?scp=0027276504&partnerID=8YFLogxK
U2 - 10.1007/BF02001013
DO - 10.1007/BF02001013
M3 - Article
C2 - 8518136
AN - SCOPUS:0027276504
VL - 7
SP - 180
EP - 186
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
SN - 0890-5096
IS - 2
ER -