Type of publication:
Journal article

Author(s):
*Anisha Sukha, *Niamh Smyth

Citation:
BMJ Case Reports 2015:published online 27 March 2015

Abstract:
A 76-year-old man was admitted with bleeding perurostomy following a collapse at home. Three weeks prior to the admission, he had undergone a radical cystoprostatectomy and formation of ileal-conduit for an extensive bladder carcinoma. A CT angiogram revealed a possible small source of bleeding within the ileal-conduit itself, which settled with conservative management. However, prior to discharge he developed profuse fresh bleeding from the urostomy, which could not be controlled. The patient underwent an emergency endoscopy of the conduit and laparotomy, which revealed a fistula between the right external iliac artery and the proximal end of the ileal-conduit. The right iliac artery was ligated and an emergency left-to-right femoral-femoral crossover bypass was performed. The right ureter was stented and rediverted through the ilealconduit and the left ureter was stented at a later date. He unfortunately had a stormy postoperative recovery with further episodes of per-urostomy bleeding and no identified source.

Link to full-text: http://casereports.bmj.com/content/2015/bcr-2014-208914.short?rss=1