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1858998 
Journal Article 
Capsule endoscopic appearance of ureteroenteric fistula in obscure gastrointestinal bleeding 
Ersoy, O; Akın, E; Karakaya, EO; Algın, O; Büyükaşık, S 
2012 
1 
The Turkish Journal of Gastroenterology
ISSN: 1300-4948 
23 
6 
815-816 
English 
23864468 
Obscure gastrointestinal bleeding (OGB) is defined as bleeding of an unknown origin that persists or recurs after negative initial endoscopies (1). Capsule endoscopy (CE) has been recommended as the third diagnostic test for patients with OGB (2). The etiological causes of small intestinal bleeding are tumors, Meckel's diverticulum, Crohn's disease, vascular lesions, and nonsteroidal antiinflammatory drug-induced small bowel disease (3). Ureteroenteric fistula is known to be a rare cause of OGB. A 38-year-old female had undergone surgery for cervical carcinoma in August 2009. A ureteral injury had developed as a complication during the procedure and was repaired intraoperatively. Thereafter, in December 2010, ureteroplasty and double-J stent insertion were performed for ureteral stricture. In the postoperative period, during the follow-up for surgical wounds and double-J stent, a urinary tract infection was detected. As she was treated for this infection, she developed hematochezia accompanied by a concurrent hematuria. No lesion could be found on the lower and upper gastrointestinal (GI) endoscopies. Subsequently, she referred to our clinic for further investigation. On CE, a lesion compatible with ureteroenteric fistula was observed at the distal small intestine (Figure 1). Magnetic resonance (MR) enterography revealed that the double-J stent was displaced and there was a fistula between the ureter and ileum (Figure 2 A, B, C). Ureteroenteric fistula is a rare cause of GI hemorrhage of unknown etiology. To our knowledge, this is first case of CE appearance of the ureteroenteric fistula.