A 45-Year-Old Man with a History of End-Stage Renal Disease

A 45-year-old man with a history of end-stage renal disease undergoes renal allograft transplantation.  The donor kidney and proximal ureter are transplanted in the right iliac fossa, with implantation of the ureter into the patient's bladder.  Six days following surgery, the donor kidney appears to be functioning well, but the patient develops fever and right lower quadrant abdominal pain.  Imaging studies reveal a large pelvic fluid collection.  Exploratory laparotomy is performed and discovers urinary leakage, with significant ischemia and necrosis of the transplanted ureter immediately adjacent to the site of implantation into the bladder.  The proximal portion of the ureter appears normal.  The healthy segment of this patient's transplanted ureter is most likely receiving blood from which of the following arteries?

A) Common iliac artery
B) Internal iliac artery
C) Lumbar arteries
D) Phrenic artery
E) Renal artery
F) Superior vesical artery

Correct Answer:

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