Non-Traumatic Ureteral Rupture Despite Initial Normal Appearance Assessed by Computed Tomography

SUMMARY 

Rupture of the urinary collecting system with urinary extravasations is a condition that leads to presentation of abdominal pain. The most common cause is usually associated with urolithiasis related obstructive nephropathy. A man aged 69 years suddenly suffered from intense pain over the left hemi-abdomen and flank area. The initial imaging studies of plain film, abdominal sonography, and enhanced and non-enhanced computed tomography scan were unremarkable. Post-contrast plain film showed left-sided urinary extravasations. Surgical intervention ensued and the patient recovered without later urinary complaints. We found that a delayed plain film after intravenous contrast media for computed tomography is helpful to evaluate the urinary tract in its entirety. It is also practical and useful for the detection of leakage from the urinary tract.

Key Words:  computed tomography , extravasation , non-traumatic ureteral rupture

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