Intraperitoneal Rupture of the Ureter as a Cause of Generalized Peritonitis: Report of a Case

Abstract

We report a rare case of generalized peritonitis caused by nontraumatic, intraperitoneal rupture of the ureter. An 80-year-old woman with a history of bilateral vesicoureteral reflux and long-term urethral indwelling catheter drainage presented with a very distended abdomen. Computed tomography showed massive ascites and intraperitoneal free gas. We performed an emergency laparotomy, assuming a gastrointestinal perforation; but could not find a cause of generalized peritonitis. Postoperatively, she presented with anuria and massive peritoneal drainage. The findings of a cystogram confirmed intraperitoneal ureteral rupture. She was managed successfully with ureteral stenting. The diagnosis of this condition requires a high degree of clinical suspicion, along with radiographic evidence and peritoneal fluid analysis. Image-guided interventions play a crucial role in the management of ureteral urine leaks after a correct diagnosis has been made.

Peritoneal perforation and peritonitis after antegrade double‐J stent insertion: A case report and review of the literature

“…In the right circumstances, these interventions may eliminate the need for open surgery, as in our case. 15 …”

“…In the right circumstances, these interventions may eliminate the need for open surgery, as in our case. 15 Several policies may be used to diminish the risk of such migration: The guidewire should not be forced blindly through the ureter; the urologist should use hydrophilic wire to prevent the wire from transient into the submucosal layer. Furthermore, choosing the optimal length of the DJ stent, the optimal sent material, and the appropriate position may be beneficial in preventing these complications.…”

Urinary bladder rupture secondary to indwelling catheterisation: two case reports

“…Presentation with acute abdomen and peritonitis is rare, as many patients are chronically debilitated with impaired sensation. [10][11][12] The cardinal sign of gross haematuria is uncommon, especially in the first 24 to 36 hours of rupture. 9,13,14 Signs of progressive abdominal distension with anuria, or frank discrepancy between bladder irrigation balance should prompt further investigations.…”