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After implantation of aorto-femoral grafts, primary ureteral lesions and secondary ureteral obstructions are the most important urological complications. Surgical repair carried out as quickly as possible, including reanastomosis without tension and covering with a peritoneal patch or omentum interposition, seems the best means of preventing secondary complications. In the case of secondary obstructions, the interval between implantation of the graft and the diagnosis of obstruction has to be considered. A wait-and-see strategy is justified in the case of early obstruction without symptoms during the 1st year because of the high rate of spontaneous remission. Obstructions that appear more than 1 year after operation or symptomatic obstructions have to be treated immediately (i.e. duodenojejunal stent, percutaneous nephrostomy). If repeated obstructions after removal of stents or nephrostomies are noted, surgical repair seems to be indicated. Stents or nephrostomies as definitive procedures are appropriate only in patients in whom surgical revision is not possible or desirable.

The current clinical and therapeutic status of spontaneous intestinal biliodigestive fistulae in 14 of the author's own cases is presented. Two groups are distinguished: those "short-circuit" connections to the gastro-intestinal tract due to biliary disease--the biliodigestive fistula in the narrower sense as well as enterobiliary fistulae caused by gastro-intestinal disease. Differences in etiology, clinical presentation, therapy and operative lethality make it seem advisable to form two categories, A and B, and to compare the one with the others.

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