Muhammet GUZELSOY, Baran TAN, Ali Riza TURKOGLU, Soner COBAN, Ufuk AYDIN

A Rare Cause of Anuria: A Case of Inflammatory Iliac Aneurysm

The patient was a 68-year-old male. The patient of complaint was anuria. There was no sense of urination. Abdominopelvic ultrasonography USG and abdominopelvic computed tomography CT without contrast revealed an empty bladder and the presence of bilateral hydroureteronephrosis. Aneurysms in the aorta and bilateral iliac arteries were detected. It caused bilateral hydroureteronephrosis via compressing “aneurysmal bilateral ureter”. Creatinine was 4.97 mg/dL, BUN 37 mg/dL, C reactive protein CRP 193 mg/L and erythrocyte sedimentation rate ESR 99 mm/h. A double J stent was inserted on the right and a nephrostomy tube was placed on the left. The urea and creatinine levels returned to normal postoperatively. Urinary obstruction or anuria can develop due to a lot of reasons such as stricture, urolithiasis, clot, and malignancy or inflammation of peripheral organs and etc. Abdominal aortic aneurysm AAA or iliac artery aneurysm IAA is a very rare cause of urinary obstruction or anuria. Abdominal aortic aneurysm AAA and iliac artery aneurysm IAA are rare factors that can cause urological symptoms with an inflammatory or direct compressive effect. There have been very rarely reported as a cause of acute anuria. We present a case of acute anuria due to bilateral inflammatory iliac artery aneurysm

Keywords:

Anuria, bilateral hydroureteronephrosis, iliac aneurysm, inflammatory,

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Forsdahl SH, Singh K, Solberg S, Jacobsen BK. Risk factors for abdominal aortic aneuryms: a 7 years prospective study: the Tromso Study. Circulation 2009;119:2202–2208.[CrossRef]
Kashyap VS, Fang R, Fitzpatrick CM, Hagino RT. Caval and ureteral obstruction secondary to an inflammatory abdominal aortic aneurysm. J Vasc Surg 2003;38:1416–21.[CrossRef]
Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Open Surgery for Giant Bilateral Internal Iliac Artery Aneurysms with Compression of Neighboring Abdominal Structures: A Case Report. Ann Vasc Dis 2015;8:265–267.[CrossRef]
Galosi AB, Grilli Cicilioni C, Sbrollini G, Angelini A, Maselli G, Carbonari L. Inflammatory abdominal aortic aneurysm presenting as bilateral hydroureteronephrosis: A case report and review of literature. Arch Ital Urol Androl 2014;86:385–386.[CrossRef]
Mujtaba B, Jan MF. Answer to case of the month #157: anuria in the supine position. Can Assoc Radiol J 2009;60:281–282.[CrossRef]
Meecham L, Koo V, Rajjayabun P. Uretero-iliac artery aneurysm fistula: A rare but fatal cause of haematuria. J Surg Case Rep 2012:16. [CrossRef]
Tang T, Boyle JR, Dixon AK, Varty K. Inflammatory Abdominal Aortic Aneurysms. Eur J Vasc Endovasc Surg 2005;29:353–362.[CrossRef]
Pennell RC, Hollier LH, Lie JT, et al. Inflammatory abdominal aortic aneurysms: a thirty-year review. J Vasc Surg 1985;2:859–869. [CrossRef]
Bonnet P, Vandenberg C, Limet R. Treatment of urological complications related to aortoiliac pathology and surgery. Eur J Vasc Endovasc Surg 2003;26:657–664. [CrossRef]
Nevelsteen A, Lacroix H, Stockx L, Baert L, Depuydt P. Inflammatory abdominal aortic aneurysm and bilateral complete ureteral obstruction: treatment by endovascular graft and bilateral ureteric stenting. Ann Vasc Surg 1999;13:222–224. [CrossRef]
Jetty P, Barber GG. Aortitis and bilateral ureteral obstruction after endovascular repair of abdominal aortic aneurysm. J Vasc Surg 2004;39:1344–1347.[CrossRef]