Endoscopic closure of ureterointestinal fistula (mucous patch)

Abstract

Fistulas are abnormal communications between two epithelialized surfaces. Due to the proximity between the digestive and urinary tracts, involvement of the urinary tract by digestive diseases and vice versa is not uncommon. The literature on this point is scarce, which represents a challenge in terms of diagnosis and treatment of these situations. We present the case of a 79-year-old female patient, with a diagnosis of rectosigmoid junction adenocarcinoma (mucosal neoplasm), where a low anterior resection plus colorectoanastomosis plus preparation of a protective ileostomy was performed with incidental lesion of the left ureter in the middle portion that warranted placement of a double J catheter complicated with recurrent urinary tract infections. Removal of the left double J catheter was planned, requesting urotomography where the passage of iodinated contrast from the left ureter to the colon and rectum was observed, establishing the diagnosis of ureterointestinal fistula, resolving said fistula endoscopically, performing mucosal closure with argon plasma and hemo clips, which were performed without complications observing complete closure of the orifice.