Lower polar aberrant renal vein-renal pelvis fistula: a rare cause of haematuria.
BACKGROUND
Non traumatic fistula between a lower polar aberrant renal vein and renal pelvis is a very rare condition, which to our knowledge has not been previously reported in the English literature.


OBJECTIVE
To report a rare case of non-traumatic fistula between an aberrant lower polar renal vein and renal pelvis.


METHODS
An 80-year old man presented with six-week history of intermittent haematuria. He was fully assessed clinically in addition to having an intervenous urography, ultrasonography, ureteropyelogram and selective right renal angiography and the venography which confirmed the presence of a fistula between the right renal pelvis and an aberrant tortuous lower polar right renal vein just above the level of the pelviureteric junction. There was no communication with an artery. The fistula was successfully treated by selective angiographic (venographic) embolization using a coil. Immediately after the emboliza-tion the haematuria settled.


CONCLUSIONS
In our opinion renal veno-pelvis fistulae should be managed in the first place by selective angiography to confirm the diagnosis and then by embolization at the same sitting. If embolization fails, then surgical closure of the fistula may be achieved either through laparoscopic or open surgical approach and the vessel may be ligated or occluded.
Venyo
A K
AK
North Manchester General Hospital, Department of Urology, Delaunays Road, Crumpsall, Manchester, M8 5RB, UK. akodzogrey@yahoo.co.uk
Shah
S
S
D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects; D006417:Hematuria / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007682:Kidney Pelvis / Q000000981:diagnostic imaging*; D008297:Male; D010690:Phlebography / Q000009:adverse effects; D012082:Renal Veins / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000009:adverse effects