Background: Ureteroarterial fistulae are very rare life threatening conditions, which, if not suspected and treated promptly, may cause a massive hematuria leading to a shock, exsanguination and
death. We would like to describe a case of a patient with a fistula between the ureter and aorto-femoral graft, which occurred nine years after the vascular operation.Case Report: A 55 year-old man came to the emergency department complaining on the pain in the right lumbal area and voiding gross hematuria with a big difficulty to void. He was hemodynamically stable, without anemia symptoms. Nine years ago, the patient had undergone aortofemoral bypass graft on the right side, due to the aortoiliac occlusive disease. In the retrograde pyelography, in the operating room conditions, an uretero-arterial fistule beetwen the ureter and the graft appeared. After retrograde pyelography we didn’t observe any hematuria. In theDepartment of Vascular Surgery, the patient uderwent the right axilofemoral bypass graft surgery, with removing of the old aorto-femoral graft and right nephrectomy at the same time. He was discharged from the Department of Vascular Surgery in good condition on the 10th day after operation, to be further controlled in the vascular health center.Conclusions: This kind of a fistula is a very rare clinical condition, but a heavy hematuria in patients that underwent a vascular prosthetic surgery in the past, should alert the clinician to a possibility of an ureteroarterial fistula.

Keywords: Hematuria, uretero-arterial fistula