Spontaneous Pelvic Rupture as a Result of Renal Colic in a Patient with Klinefelter Syndrome

Abstract

We present the case of a young man with Klinefelter syndrome, who was admitted to our clinic with renal colic. Shortly after admittance, spontaneous decrease in pain has occurred. Ultrasound and intravenous contrast computed tomography were performed, which showed the evidence of urine extravasation at the level of left renal pelvis and a 4 mm stone in the lower third of the left ureter. The management with a double-J ureteric stent for three weeks was successful. Then, the stent was removed and computed tomography confirmed the absence of urine extravasation. We also analyze the literature related to this case and discuss the main mechanisms of collecting system rupture.

Spontaneous rupture of the ureter: A rare case

“…In addition, malignancy, retroperitoneal fibrosis, bladder outlet obstruction, connective tissue disease such as Klinefelter syndrome were also reported. In some cases, the cause is unknown [6][7][8][9]. In our patient, similar to the literature rupture occurred due to the ureteral calculi.…”

Tubular Dysfunction and Ruptured Ureter in a Child with Menkes Syndrome

“…It may potentially lead to urinoma, retroperitoneal abscess, and urosepsis [ 5 ]. Most of the reported cases are associated with ureteric stones [ 6 , 7 ], and rarely bladder outlet obstruction [ 8 ] or connective tissue abnormality [ 9 ]. All these risk factors were present in our patient.…”

Spontaneous rupture of the ureter

“…Impaction of stones on the ureter wall, or a downward moving calculus, which may cause erosion and ulceration of the ureteral wall, may lead to ureteral rupture at the distal ureteral obstruction. (2) In addition, (4) idiopathic retroperitoneal fibrosis, (5) posterior urethral valves or bladder outlet obstruction, (6) and some connective tissue disorders causing fibrotic changes such as Klinefelter syndrome (7) have also been proposed to be causes of spontaneous rupture of the ureter. Spontaneous rupture of the ureter during kidney biopsy, (8) as a complication of extracorporeal shock wave lithotripsy, (9) and increased urine flow from a fluid bolus (10) have also been reported.…”

“…(13) Although there have been reports of ureteral rupture being managed via open surgery, many studies have also highlighted the significant benefits of minimally invasive endourological procedures such as double-J catheter placement and percutaneous drainage. (6)(7)(8)18) Recently, successful conservative management with analgesics and antibiotic coverage has been reported in the literature. These studies recommended nonoperative treatments in stable patients, but advised that endourological intervention may still be necessary if conservative management fails.…”