Obstruction of the ileal ureter by mesenteric vessels occurring 5 years after total ureteral substitution for bilateral ureteral stenosis due to systemic lupus erythematosus.
We previously reported a case of bilateral ureteral stenosis accompanied by systemic lupus erythematosus, which was successfully managed by total ureteral reconstruction using a segment of the ileum. Herein, we describe an unusual complication in the same patient, which we experienced 5 years after the ileal-ureteral substitution. Left-sided back pain repeated together with transient obstruction of the ileal ureter interposed between the right and left renal pelvis. Consequently, exploratory laparotomy revealed that left colic vessels oppressed and caused obstruction, and the obstructed ileal ureter was released by reconstitution of these vessels instead of re-anastomosis of the ileal ureter. Left hydronephrosis and related back pain disappeared postoperatively. The number of patients with an indication of ileal-ureteral substitution is increasing for various disorders, and thus, the present report gives additional suggestions for the follow up of patients with ileal ureter.
Kobayashi
Kazuhiro
K
Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi, Niigata, Japan. kobayasi@med.niigata-u.ac.jp
Obara
Kenji
K
Watanabe
Ryusuke
R
Hara
Noboru
N
Katagiri
Akiyoshi
A
Takahashi
Kota
K
D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000098:blood supply / Q000637:transplantation*; D007813:Laparotomy; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008638:Mesenteric Arteries; D012008:Recurrence; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014567:Urography