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Case Reports
. 2017 Jan 9;2016(11):rjw192.
doi: 10.1093/jscr/rjw192.

Spontaneous proximal ureteric rupture secondary to ureterolithiasis

Keith Pace  1 , Karl Spiteri  2 , Karl German  2
Affiliations
Case Reports

Spontaneous proximal ureteric rupture secondary to ureterolithiasis

Keith Pace et al. J Surg Case Rep. .

Abstract

We present the case of a 37-year-old lady who presented with severe colicky left sided flank pain associated with vomiting, chills and rigors. A non-contrast Computed Tomography of the Kidney Ureter and Bladder was performed which showed a 2-3 mm stone in the pelvic part of the left ureter. Following 2 days of conservative treatment she was still complaining of increasingly severe pain. A contrast computed tomography of the abdomen was performed which was suggestive of a perforation of the left collecting system. A diagnosis of spontaneous left proximal ureteric perforation secondary to urolithiasis was made. We opted to treat her with retrograde endoscopic ureteric stent insertion. Spontaneous rupture of the ureter is a relatively rare urological occurrence with only a small number of cases reported in the literature. Although there are no recommendations, ureteric double-J stenting is the most commonly used management option with good results reported.

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Figures

Figure 1:
Figure 1:
A non-contrast CT KUB was performed which showed a 2–3 mm stone in pelvic part of the left ureter.
Figure 2:
Figure 2:
CT IVU- confirmed extravasation of contrast medium around the left kidney and ureter, the rupture being at the level of the PUJ.
Figure 3:
Figure 3:
Coronal view reconstructions using maximum intensity projection, showing proximal ureteric leak of contrast.
Figure 4:
Figure 4:
On table Pyelogram confirmed intact left collecting system and ureter.
Figure 5:
Figure 5:
On table Pyelogram confirmed intact left collecting system and ureter.
See this image and copyright information in PMC

References

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