MEDtube Science 2014 - Life – threatening bleeding nine years after kidney transplantation with Bricker – type ureterointestinal anastomosis

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Case description

Bricker – type ureterointestinal anastomosis is a widely used technique for performing ureteroenteric anastomosis. In some cases it is the only possible urinary drainage after kidney transplantation for patients with lower urinary tract abnormalities.
A 58–year–old female patient, nine years after kidney transplantation with Bricker – type ureterointestinal anastomosis, with recurrent urinary tract infections, was admitted to the hospital because of severe bleeding through the urostomy. Hemoglobin level was 3.4 g/dl. Patient had also imapaired cloth formatins and coagulopathy with prolonged protrombine time due to chronic hepatitis C. Ultrasound and lifesaving laparotomy showed no source of bleeding. During operation bleeding stopped spontaneously and didn’t return again. After surgery also endoscopy through stoma was undertaken. This procedure showed no source of bleeding in intestine and made more probably graft hemorrhage. Graft biopsy showed no signs of rejection. Due to progressive loss in renal function patient needed dialysis again.
The Bricker ileal conduit is a great surgical solution in some patients but like most surgical procedures has both positive and negative implications.

tags: MEDtube Science 2014 journal article bricker transplantation KIDNEY

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