Fistula between external iliac artery and ileal conduit after radical cystectomy: a life-threatening complication.

OBJECTIVE: To present a rare complication of an iliac artery to ileal conduit fistula after radical cystectomy. METHODS: A 74 year-old man with muscle invasive bladder cancer was submitted for robotic radical cystectomy with intracorporeal ileal conduit. Twenty-four days after surgery he was readmitted due to an active bleeding from the ileal conduit. RESULTS: CT-Scan showed an arterial fistula between the external iliac artery and the ileal conduit. The emergency procedure done was an artery ligation, bilateral cutaneous ureterostomy and extra-anatomic femoro-femoral bypass. CONCLUSIONS: A fistula from the external iliac artery to the ileal conduit is a rare and serious complication in the Bricker type urinary diversion, with only 7 cases reported in the international literature.

Fístula desde arteria ilíaca a conducto ileal tras cistectomía radical: una grave e infrecuente complicación con riesgo vital / Fistula between external iliac artery and ileal conduit after radical cystectomy: a life-threatening complication

OBJETIVO: Presentar un caso de fístula desde arteria ilíaca a conducto ileal, una infrecuente complicación después de cistectomía radical y derivación urinaria con conducto ileal. MÉTODOS: Paciente de 74 años, portador de un cáncer vesical infiltrante, a quien se le realiza una cistectomía radical con derivación urinaria con conducto ileal robótica totalmente intracorpórea. Reingresa 24 días después de la cirugía por sangrado brusco y activo desde el conducto ileal. RESULTADOS: Se realiza Angio-TAC que confirma el diagnóstico de una fístula entre la arteria ilíaca externa y el conducto ileal, por lo cual es operado de urgencia realizando una ligadura arterial, ureterostomía cutánea bilateral y by-pass femoro-femoral extraanatómico. CONCLUSIONES: La fístula arterial hasta el conducto ileal es una rara y grave complicación de la derivación urinaria tipo conducto ileal, con sólo 7 casos comunicados en la literatura (AU)

OBJECTIVE: To present a rare complication of an iliac artery to ileal conduit fistula after radical cystectomy. METHODS: A 74 year-old man with muscle invasive bladder cancer was submitted for robotic radical cystectomy with intracorporeal ileal conduit. Twenty-four days after surgery he was readmitted due to an active bleeding from the ileal conduit. RESULTS: CT-Scan showed an arterial fistula between the external iliac artery and the ileal conduit. The emergency procedure done was an artery ligation, bilateral cutaneous ureterostomy and extra-anatomic femoro-femoral bypass. CONCLUSIONS: A fistula from the external iliac artery to the ileal conduit is a rare and serious complication in the Bricker type urinary diversion, with only 7 cases reported in the international literature (AU)