A Case of Successful Endovascular Aortic Repair of Primary Aortoenteric Fistula Without Aortic Explantation.

PURPOSE: The objective of this study is to report a case of a primary aortoenteric fistula successfully treated with endovascular repair without aortic explant. CASE REPORT: A 48-year-old man presented with a 24-hour history of hematemesis and malena. A computed tomography (CT) abdomen and pelvis demonstrated a 6 cm infrarenal aortic aneurysm with periaortic stranding and contrast enhancement within the lumen of the third part of the duodenum. The patient underwent emergency Endovascular Aortic Repair (EVAR). The patient was discharged on day 8 of his admission on oral antibiotics. He returned 7 weeks postindex procedure and underwent a laparotomy with omental patch repair of the aortic defect. Intraoperative cultures grew candida albicans, and the patient was discharged on lifelong oral Fluconazole and Amoxycillin-Clavulanic Acid. At 18 months postoperatively, the patient was clinically stable with improved appearances on CT aortogram. CONCLUSION: We discuss the use of EVAR without aortic explant as a possible treatment option in the management of patient with primary aortoenteric fistulae. This may potentially avoid the significant morbidity and mortality associated with aortic explant in suitable candidates without perioperative signs of sepsis.

Incidental contrast opacification of the appendix secondary to urological intervention.

A 23-year-old otherwise well male, with right ureteric stent in situ placed electively for a 9-mm symptomatic pelviureteric junction stone underwent a right ureteropyeloscopy, retrograde pyelogram laser lithotripsy and stent exchange for stone clearance. The procedure was uncomplicated. Following stent removal on day 2, the patient developed acute right lower quadrant pain, which was investigated with non-contrast CT abdomen. The scan demonstrated a contrast-filled vermiform appendix, secondary to vicarious contrast excretion. This case report describes a rare manifestation of vicarious contrast excretion and explains this phenomenon.

A rare triple concurrence of ureteric calculus and renal cell carcinoma in a horseshoe kidney.

Horseshoe kidney is a rare anatomical variant with low clinical morbidity. However, the characteristic shape of horseshoe kidney causes significant anomalies within the vascular and collecting systems. This complicates the diagnosis and management of coexisting pathologies within the kidneys. Here, we report a rare case of concurrent diagnoses of ipsilateral ureteric calculus and renal cell carcinoma within a horseshoe kidney and describe the subsequent management rationale based on the current literature.

Superficial Thrombophlebitis of the Penis following AstraZeneca ChAdOx1-S Vaccination: A Rare Venous Thromboembolic Complication.

Penile Mondor's disease is a rare condition characterised by superficial thrombophlebitis of the penis which is usually self-limiting. The cause is often unknown. The AstraZeneca ChAdOx1-S vaccine has been found to cause a hypercoagulable state, which is well documented. This case report describes a man who presented with Mondor's disease following ChAdOx1-S vaccination with no other risk factors. LEARNING POINTS: This is the first documented case of penile thrombophlebitis following ChAdOx1-S vaccination.We highlight a rare presentation of an uncommon condition.Clinicians should be aware of the clotting risks associated with ChAdOx1-S vaccination.

Conservative Management of a Prostate-Symphyseal Fistula With Osteomyelitis: A Case Report and Management of a Rare Complication.

This article presents the case of a 77-year old male who was found to have a prostate-symphyseal fistula with associated pubic symphysis osteomyelitis. He had a history of previous radiation for prostate cancer and two transurethral resections of the prostate. He was managed conservatively with long-term antibiotics and urinary diversion as he was a suboptimal surgical candidate. To our knowledge, this case report is the first reported successful conservative management of a prostate-symphyseal fistula.

Not just a simple inguinal hernia. A rare case of an inguino-scrotal ureter!

Inguinal hernias involving the ureter or inguino-scrotal ureters are a rare and infrequently described finding with both clinical and surgical consequence. While the majority are asymptomatic and rarely cause obstructive uropathy our case aptly highlights the risk to a general surgeon prior to an elective hernia repair. A review of the literature outlines a systematic approach of investigation if clinical suspicion of an inguino-scrotal ureter is raised, with careful operative planning and a multidiscipline approach for repair recommended.