Ileus conduent

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Reference article, Radiopaedia. Ileal loop conduits Bricker conduit Bricker Bricker urinary diversion Ileal loop conduit Ileal loop urinary diversion Ileal conduits Bricker conduits Bricker's conduit Bricker's conduits.

URL of Article. On this page:. Quiz questions. Marc S. Levine, Parvati Ramchandani, Stephen E. Long-Term Complications of Urinary Diversion. Current Opinion in Urology. Follow the Stream: Imaging of Urinary Diversions. Related articles: Urologic procedures.

Promoted articles advertising. Case 3: loopogram with ureteroileal stricture Case 3: loopogram with ureteroileal stricture. Case 4 Case 4. Case 5: with encrusted retained stent fragment Case 5: with encrusted retained stent fragment.

Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Loading Stack - 0 images remaining. By System:. Patient Cases. Contact Us. European Association of Urology. Eur Urol Radiographics PMID: Contrast-enhanced multidetector CT-urography 20 days after surgery. Contrast-enhanced multidetector CT-urography one year after surgery. Normal postoperative anatomy after cystectomy with ileal conduit.

Home Advanced Search Case Grassi 74 Milan, Italy; Email:mtonolini sirm. Connected authors. Show more Show less. Clinical History. High-grade fever, generalised malaise, and laboratory finding of elevated acute phase reactants following recent hospital discharge after radical cystoprostatectomy with iliac-obturator lymphadenectomy and incontinent ureteroileocutaneostomy Bricker urinary diversion for pT2N0 transitional cell carcinoma of the urinary bladder.

Renal function within normal limits despite raising serum creatinine compared to preoperative status. Imaging Findings. Compared to usual postoperative appearances after radical cystectomy with Bricker diversion Fig. The enteroenteric stapled anastomosis indicated site of ileal resection for conduit creation.

The patient improved after intensive antibiotics eradicated urinary infection. Four months later, ultrasound Fig. One year after surgery, follow-up CT-urography Fig.

The unopacified left ureter tapered towards the ureteroileal anastomosis, without appreciable tumour tissue. Despite normal right side appearances, normal functioning of urostomy and conduit, and the absence of local, nodal or distant neoplastic recurrence, the patient had a non-functioning left kidney at renal scintigraphy.

Antegrade stenting could not relieve the tight fibrotic ureteroileal anastomotic stricture. Urinary reconstruction is obtained with either continent catheterizable cutaneous reservoir or orthotopic neobladder or incontinent diversions such as ureterocutaneostomy and ileal conduit IC.

Initially described by Bricker, IC remains an established option for patients that are not candidates for continent diversion, and includes creation of bilateral ureteroenteric anastomoses draining urine into a detached cm ileal segment, which is brought out through an abdominal wall stoma [].

After RC, cross-sectional imaging is needed to investigate postoperative complications and detect recurrent cancer and metachronous urothelial tumours. Multidetector CT-urography is the technique of choice to visualize the postoperative anatomy and correctable problems, aiming to prevent renal impairment.

The IC is seen extending to the urostomy, and the collecting systems and ureters typically wider due to prior obstruction or reflux up to the ureteroileal anastomosis []. Furthermore, common postoperative events such as pneumonia and deep venous thrombosis may be diagnosed []. Infections occur, either as early or late recurrent complications of urinary diversion, due to impaired defence mechanisms. CT-urography findings include pyeloureteral thickening and hyperenhancement, pyelonephritis, renal or perirenal abscesses [].

Often clinically silent, obstructive complications are diagnosed by imaging or suggested by rising serum creatinine, and may lead to deterioration of renal function. Conduit and stomal strictures manifest as dilated reservoir with bilateral hydronephrosis.

More commonly, late postoperative stricture occurs at the ureteroileal anastomosis within years, resulting from fibrosis triggered by ischaemia.

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