Ureterogluteal Fistula Following Ureteral Penetrating Trauma: Case Report

Traumatic injuries of the ureter constitute only 1% of the total traumatic injury of the genitourinary tract. Most penetrating ureter injuries occur during surgery. Ureteral injuries in cases of external trauma are often accompanied by the injury of the adjacent visceral bodies and may be disturbed by the prevalence of manifestations and signs of injury to other viscera. In cases where penetrating ureter trauma is neglected, the patient complaints of signs & symptoms of ureteral damage later. Among these complications, the formation of the fistula between the ureter and adjacent vessels, the vagina or skin rarely occurs. The patient was a 56-year-old man who had come to our hospital with a history of falling on a rebar and entering the metal fractures in the right gluteal region about 20 days ago with a complaint of clear fluid leakage from the wound site. The patient was referred to another hospital at the time of the incident, and after discharge, he had no any symptoms. At that time, the result of the CT scan was normal. Several days after the initial accident, the patient went to our hospital with Transparent fluid leakage from wound site. An outflow fluid test showed urine. results of IVP and CT scan showed that there was a fistula between the ulcer site in the gluteal region  and ureter. After completing the tests, the patient was transferred to the operating room and ureter was repaired and the fluid leak was completely discontinued. The ureteral trauma in more than one-third of all cases of multiple trauma are not considered. Because the complications of neglected trauma are numerous and sometimes very risky, the surgeon in each case of penetrating abdominal trauma should consider the possibility of ureteral damage. Presentation of ureterogluteal fistula in published articles are rare. The purpose of this article is to introduce this rare case.