Spontaneous urinary extravasation: detection rate with 64-row multidetector computed tomography in patients presenting with acute abdomen

Abstract

The aim of this study was to detect the rate of spontaneous urinary extravasation (SUE) with computed tomography (CT) in patients presenting with acute abdomen. Seven hundred thirteen abdominal CT examinations with i.v. contrast media requested mainly from the emergency department and urology clinics for sudden onset abdominal pain, flank pain, nonspecific abdominal pain with nausea and vomiting, and renal colic between September 2007 and August 2011 were retrospectively reviewed. Only adult patients were included in the study. Three patients with SUE were detected. One had a mid-ureteral stone while the etiology for the other two patients was unknown. Two of the patients were treated conservatively; one was treated with stenting with a double-j catheter. SUE should be considered in the differential diagnosis of patients presenting with acute abdomen and perinephric-periureteral fluid collection inconsistent with stone size and who are occasionally stone free. Early and precise diagnosis of SUE plays an important role in the management protocol of patients presenting with acute abdomen.

Spontaneous Ureteral Urine Extravasation From Invasion of a High-grade Angiosarcoma

“…Spontaneous ureteral urine extravasation is a rare occurrence and is defined as perforation not induced by iatrogenic manipulation, external trauma, degenerative kidney disease, urography with external compression, or previous surgery 1 . The most common causes of spontaneous ureteral urine extravasation are stone disease (56%) and stricture (16.7%), and tumor (5.6%) 2 .…”

The relative contribution of urine extravasation to elevation of plasma creatinine levels in acute unilateral ureteral obstruction

“…3 As high as 18% of patients with acute ureteral obstruction also present with peri-renal urine extravasation (PUE). 4,5 Moreover, peri-renal edema and tissue stranding were reported in up to 65% of renal colic imagings due to obstructing stones. 6 Several previous studies have inconsistently described urine extravasation as either a good prognostic sign for spontaneous stone passage, shorter hospitalization and fewer subsequent therapeutic procedures, or associated with delayed diagnosis, infection and renal failure in the clinical setting of ureteral obstruction.…”

Acute Unilateral Ureteric Obstruction in Young Men With High Serum Creatinine: Is It True or False Renal Impairment?

“…As high as 18% of AUUO may present with urine extravasation due to increased intrapelvic pressure. Absorption of extravasated urine or obstructed urine in AUUO into circulation elevates serum creatinine levels [7,8]. Recently, published animal study proved that in AUUO, back flow of obstructed urine into venous and lymphatic vessels causes elevation of serum creatinine.…”