| An 86-year-old patient with a history of prostatic neoplasia diagnosed 14 years ago, who had undergone aneurysm surgery (endoprosthesis placement and chronic ischemic pulmonary insufficiency), 12 years ago with no acute edema, performed in another hospital | |
| In August 2004, the patient came to the emergency department with a worsening of chronic renal failure. A renal ultrasound showed a right atrophic kidney with left iliac artery disease due to probable iliac artery aneurysm. | |
| We performed ureteral catheterisation with double J catheter, improving renal function values. | |
| In October 2004 he will be re-internted in the Nephrology Service for acute chronic renal failure, where a central catheter will be placed to start hemodialysis program. | |
| Two days later, the patient developed macroscopic hematuria with hemodynamic instability and a pulsatile abdominal mass. | |
| The patient underwent emergency computed tomography (CT) of probable ruptured iliac aneurysm in the left ureter with moderate stenosis demonstrating left hydronephrosis and atrophic right kidney. | |
| 1. | |
| In the operating room we observed rupture of aneurysm of the left internal iliac artery with fistula to the ipsilateral ureter, ureter with ulcerated and necrotic appearance and large perirenal hematoma. | |
| The internal iliac artery will be ligated by endoaneurysmal approach, the fistula of the iliac-ureteral aneurysm and left nephrectomy. | |
| The patient dies fifteen days after surgery. | |