Rupture of the renal pelvis of a ureteropelvic junction hydronephrosis after blunt abdominal trauma

Ashebu, S. D.; Dahniya, M H; Aduh, Prosper; Ramadan, Salwa; Bopaiah, Harini; Elshebiny, Yahaya H

doi:10.1111/j.1440-1673.2004.01283.x

Cited by 18 publications

(8 citation statements)

References 19 publications

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“…Most commonly, renal urine leaks result from trauma (4,5). Obstruction of the genitourinary system due to a stone, pelvic mass, pregnancy, retroperitoneal fibrosis, or posterior urethral valves can increase intraluminal pressure and cause rupture of the collecting system.…”

Section: Discussionmentioning

confidence: 98%

Spontaneous Rupture of the Renal Pelvis Caused by Calculus: A Case Report

Köktener

Unal

Dilmen

et al. 2007

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 98%

Spontaneous Rupture of the Renal Pelvis Caused by Calculus: A Case Report

Köktener

Unal

Dilmen

et al. 2007

The Journal of Emergency Medicine

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“…Rupture of the renal pelvis with extravasation of urine into the perinephric and/or retroperitoneal space is a rare condition most often resulting from trauma [1], but also associated with obstructing ureteral calculi, or compression of the ureter by pregnancy [2], tumor or retroperitoneal fibrosis [3]. Flank and abdominal pain are the most common presenting symptoms, and ultrasonography and computed tomography (CT) are the initial diagnostic modalities of choice.…”

Section: Resultsmentioning

confidence: 99%

Spontaneous rupture of the renal pelvis due to an obstructing ureteral calculus diagnosed by point-of-care ultrasound

Stone

Secko

2010

Crit Ultrasound J

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A 37-year-old man presented to the emergency department with left flank pain and vomiting. Bedside ultrasound performed by the treating emergency physician revealed left-sided hydronephrosis and perinephric fluid, suggesting a rupture of the renal pelvis. Urinary sonography revealed an absent left ureteral jet, suggesting left ureteral obstruction. Treatment was initiated and a noncontrast computed tomography scan confirmed the initial ultrasound findings.A 37-year-old man with no prior medical history presented to the emergency department (ED) 4 h after the onset of acute left flank pain and vomiting. He denied fever, diarrhea, dysuria, or trauma. His temperature was 98.2°F, pulse 104/min, respirations 18/min, blood pressure 142/78 mm Hg, and his room air oxygen saturation was 98%. His physical examination was remarkable for left costovertebral angle tenderness. His abdomen was soft and non-tender without rebound or guarding. A mid-stream urinalysis showed 0-2 red blood cells/high powered field.The treating emergency physician performed a bedside ultrasound using a 5-2 MHz curvilinear transducer (Sonosite M-Turbo, Bothell WA). Examination of the left kidney demonstrated moderate hydronephrosis and an anechoic fluid collection surrounding the left kidney consistent with a calyceal rupture and pyelosinus extravasation ( Fig. 1; h = hydronephrosis, asterisks = fluid collection, and Video Clip S1, available as supporting information in the online version of this paper). Although power Doppler examination of the bladder demonstrated a ureteral jet from the right ureteral orifice (Fig. 2), no ureteral jet was visible on the patient's left, indicating a left ureteral obstruction. Results and discussionNon-contrast computed tomography (CT) scan of the abdomen and pelvis confirmed a 5 mm obstructing left ureterovesical junction (UVJ) stone ( Fig. 3; b = bladder, asterisk = stone) with left-sided hydronephrosis and perinephric fluid ( Fig. 4; h = hydronephrosis, asterisk = perinephric fluid). The patient was evaluated by an urologist after his symptoms were controlled with antiemetics, analgesics, and intravenous crystalloid. He was discharged home with oral antibiotics and opiate analgesics, an alpha 2-antagonist, and a follow-up appointment in the urology clinic 48 h later. Chart review revealed that the patient recovered uneventfully without any surgical intervention.Rupture of the renal pelvis with extravasation of urine into the perinephric and/or retroperitoneal space is a rare condition most often resulting from trauma [1], but also associated with obstructing ureteral calculi, or compression of the ureter by pregnancy [2], tumor or retroperitoneal fibrosis [3]. Flank and abdominal pain are the most common presenting symptoms, and ultrasonography and Electronic supplementary material The online version of this article (

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“…Patient with normal urinalysis could sustain major ureteral, renal pelvis, or renal injury. Therefore, the decision on renal imaging for the diagnosis of injury and its subsequent therapeutic management should be based on the presence and extent of hematuria along with patient's clinical status, postulated mechanism and site of injury, and extent of associated injuries [9]. Ultrasonography could be used as a simple screening tool but often is not accurate enough [11,13].…”

Section: Discussionmentioning

confidence: 99%

“…It is a rare clinical entity [6][7][8][9]. Reported cases of traumatic rupture of the kidney or ureter usually reflect underlying renal pathologic condition.…”

Section: Discussionmentioning

confidence: 99%