Spontaneous rupture of renal pelvis as a rare complication of ureteral lithiasis

Porfyris, Orestis; Apostolidi, Elena; Mpampali, Andromachi; Kalomoiris, Paraskevas

doi:10.5152/tud.2015.92979

Cited by 15 publications

(23 citation statements)

References 7 publications

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“…The urine leak localizes itself in the place of the lowest tensile strength, that is, the fornix of renal calyx in most cases [ 8 ]. The extent of the rupture is considered to be self-limiting [ 3 , 9 ], as the extravasation of urine decreases intrapelvic pressure, preventing other structures of the collecting system from being damaged. Renal forniceal rupture can be treated conservatively and poses little risk of sequelae [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…A review of the documented cases shows the renal fornix to be the most common rupture site; ruptures of renal pelvis or ureteropelvic junction are very rare occurrences [ 1 ]. The disruption of the pelvicalyceal system may result from an elevated intrapelvic pressure, typically secondary to urinary tract obstruction [ 2 , 3 ]. Ureteric calculi are reported to be the leading cause of this complication; less common causes include malignancies, pregnancy, posterior urethral valves, ureteropelvic junction obstruction, and medications [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney

Tylski¹,

Muras-Szwedziak²,

Nowicki³

2021

Case Rep Nephrol Dial

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Spontaneous rupture of renal pelvis (SRRP) is a rare condition resulting in an extravasation of urine into retroperitoneal space. Due to the uncharacteristic symptoms, often mimicking renal colic, its diagnosis may be complicated. Herein, we report a case of a 73-year-old male with a solitary functioning kidney who presented with malaise and right-sided abdominal pain, rapidly followed by anuria. Laboratory tests showed the signs of AKI. Contrast-enhanced CT performed soon after the admission showed nonspecific abnormalities in the right middle abdomen suspected to be either inflammatory infiltration or surgical scarring. Symptomatic treatment was started, and an acute hemodialysis treatment was commenced. After a temporal improvement, the patient’s general condition worsened significantly, with exacerbated pain and massive increase in plasma creatinine. A second contrast-enhanced CT was performed with an addition of urography phase, revealing the extravasation of the contrast media in the location suggesting the rupture of the renal pelvis. The patient was treated successfully by the placement of a double-J ureteral stent into the ureter. Usually, a clear etiology of SRRP can be determined, that is, urinary tract obstruction, but in this case, we could not find a definite cause. It is important to remember that in the presence of a nonspecific abdominal pain and laboratory signs of AKI, a rare cause like SRRP should be taken into consideration. Performing a contrast CT scan with urography phase can save time in establishing a diagnosis and enable immediate urological intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney

Tylski¹,

Muras-Szwedziak²,

Nowicki³

2021

Case Rep Nephrol Dial

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“…In a subcapsular urinoma, there is urine between the capsule and parenchyma of the kidney. Conversely, perirenal urinomas are characterized by the collection of urine in between the capsule and the Gerota’s fascia [ 8 ]. In many cases, there is leakage of urine into the perirenal or subcapsular space within Gerota’s fascia with wide extravasation, along with the flow of urine across through lymphatic vessels [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Appendicitis Mimicking Urinoma: A Challenging Emergency Presentation Secondary to Ureteric Stone

Elmoheen¹,

Ponappan²,

John³

et al. 2021

Cureus

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This article describes the case of a 38-year-old male who presented to the ED with three days history of gradually progressing right-sided lower abdominal pain, which had increased in severity two hours prior to his ED visit. The patient was anorexic but denied experiencing any fever, urinary malfunctions, or chills. Blood tests showed an elevated serum creatinine level of 123 umol/L and a high C-reactive protein level of 62 mg/L. Bedside point-of-care ultrasound (POCUS) imaging showed right-sided mild hydroureteronephrosis with surrounding perinephric fluid. Initially, based on the patient's presentation and clinical findings, appendicitis or ureteric colic was strongly suspected. CT of the abdomen with contrast revealed urinoma measuring 16 cm, and there was a 3.2 mm calculus in the distal part of the right ureter, with perinephric and periureteric fat stranding. This rare phenomenon requires prompt care. Delayed medical treatment may result in complications like hydronephrosis, abscess, distorted electrolyte levels, and gradual loss of renal function. Small urinomas are usually treated conservatively, while large-sized urinomas often require aggressive medical treatment. A drainage catheter under CT or ultrasound guidance may be done, and additional decompression and drainage may be needed with percutaneous nephrostomy tubes. The fluid and urine culture guide antibiotic treatment.

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“…İlk olarak 1856 yılında Wunderlich tarafından tanımlanan spontan renal pelvis rüptürü obstrüktif üreter taşlarının nadir bir komplikasyonudur (3). İleri sürülen mekanizma intrapelvik basıncın ani artışı ile pelvis dokusunun gerilime dayanma gücünün aşılmasıyla oluşan defektten idrar ektravazasyonudur.…”

Section: Discussionunclassified

Renal Pelvisin Spontan Rüptürü: Obstrüktif Üreter Taşının Nadir Bir Komplikasyonu

Ateş¹,

Amasyalı²,

Erol³

2018

Akd Med J

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Toplayıcı sistemin spontan rüptürü üreter taşı kaynaklı obstrüksiyonların nadir görülen bir komplikasyonudur. Oluşan minimal kaçak spontan rezorbe olabilirken absorbe edilebilenden daha fazla miktardaki idrarın perirenal veya periüreteral alana sızmasıyla ürinom oluşur. Biz de spontan renal pelvis rüptürü neticesinde minimal idrar kaçağı ve ürinom gelişen iki olguya yaklaşımımızı ve literatürdeki tedavi stratejilerini sunmayı amaçladık. Bu iki olguda semptomların kontrolü ve ekstravazasyonun giderilebilmesi için double J stent kateterizasyon uyguladık. İki olguda da postoperatif kontrollerde sıvı koleksiyonunun kaybolduğu ve hidronefrozun gerilediği görüldü. Üreter taşının büyüklüğüne ve lokalizasyonuna, ürinomun genişliğine, hastanın diğer ek patolojilerine ve semptomlarının şiddetine göre konservatif, girişimsel ya da cerrahi tedaviler uygulanabilir.

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Spontaneous rupture of renal pelvis as a rare complication of ureteral lithiasis

Cited by 15 publications

References 7 publications

Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney

Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney

Appendicitis Mimicking Urinoma: A Challenging Emergency Presentation Secondary to Ureteric Stone

Renal Pelvisin Spontan Rüptürü: Obstrüktif Üreter Taşının Nadir Bir Komplikasyonu

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