JUNIPER PUBLISHERS-Advanced Research in Gastroenterology & Hepatology
A Rare Case of Ureteroileal Fistula from Indian Tertiary Care Center
Authored by Richa Sharma*
A sixteen-year-old girl reported to
department of Gastroenterology, Manipal Hospital, Jaipur with history of
chronic diarrhoea, this diarrhoea was there for 3 months, with watery stool,
diarrhoea having no relation to food intake, times of the day, not relieving
with any medicine tried, patient seen my many gastroenterologists earlier
normal duodenoscopy and full colonoscopy, no ileoscopy done. There was history
of laparoscopic cholecystectomy a few months back for symptomatic gall stones
for which she was operated, postsurgery one week was uneventful, then she
developed diarrhoea, diagnosis was kept as bile acid diarrhoea treated
conservatively and family reassured for gradual recovery, but diarrhoea did not
improve, bile acid binding agent did not work, course of anthelminthic,
antidiarrheal, modified diet did not work, there was no weight loss, family was
distressed, met me at OPD parents and the girl all were weeping as she was
troubled due to watery diarrhoea day and night, unable to sleep. Two points she
told after detailed discussion that after more water intake diarrhea worsens
and before motion, she felt pain in the right iliac fossa. As we suspected some
kind of spurious diarrhea due to surgical complication and communication of
intestine and ureter, we sent stool sample of the patient for urea creatinine
measurement, stool creatinine was 30mg/dl and stool urea was 700mg/dl. It
supported the diagnosis of spurious diarrhea (urine coming from bowel as the
watery stool).
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