Citation, DOI, disclosures and article data
At the time the article was created Jeremy Jones had no recorded disclosures.View Jeremy Jones's current disclosures
At the time the article was last revised Mostafa El-Feky had no recorded disclosures.View Mostafa El-Feky's current disclosures
Ureteric rupture is rare but has been described. It may be spontaneous or secondary to another pathology or intervention.
On this page:
The most common symptoms are sudden, severe, persistent lower abdominal pain with severe peritoneal irritation. Abdominal compartment syndrome, respiratory distress, and anuria have also been reported.
Most common causes of ureteric injuries are traumatic, with non-traumatic cases being much less frequent. Some of the common causes are:
- blunt, or less commonly, penetrating trauma
- neoplastic processes of the ureter or surrounding invading tumors
- obstruction and dilatation, e.g. ureteric calculi, obstructing tumor
- instrumentation, e.g. cystoscopy, ureteric stent insertion
It has been described as a sensitive method in diagnosing ureteric rupture; nevertheless, the expected poor resolution of this study in unprepared patients make it less favorable compared to CT.
CT is considered the optimal evaluation for diagnosing ureteric rupture. The accurate size and location of the urinoma, as well as its progression can be assessed with delayed (excretory) phase images.
Treatment and prognosis
Many authors have resorted to open surgery earlier for complete management of spontaneous rupture and urinoma. However, Stravodimos et al reported successful treatment of ureteric rupture by the insertion of a double-J ureteric stent under fluoroscopy.
Complications of ureteric stricture, ureteropelvic stenosis, or peri-ureteric fibrosis are expected, yet their true incidence remains unknown.
- 1. Smith M, Johnston B, Wessells H et-al. Trauma cases from Harborview Medical Center. Rupture of a ureteropelvic junction-obstructed kidney in a 15-year-old football player. AJR Am J Roentgenol. 2003;180 (2): 504. doi:10.2214/ajr.180.2.1800504 - Pubmed citation
- 2. Geoghegan T, Benfayed W, Torreggiani WC. Rupture of ureteropelvic junction-obstructed kidney. AJR Am J Roentgenol. 2003;181 (3): 886. doi:10.2214/ajr.181.3.1810886a - Pubmed citation
- 3. Hall SJ, Carpinito GA. Traumatic rupture of a renal pelvis obstructed at the ureteropelvic junction: case report. J Trauma. 1994;37 (5): 850-2. Pubmed citation
- 4. Ashebu SD, Dahniya MH, Aduh P et-al. Rupture of the renal pelvis of a ureteropelvic junction hydronephrosis after blunt abdominal trauma. Australas Radiol. 2004;48 (2): 256-8. Australas Radiol (full text) - doi:10.1111/j.1440-1673.2004.01283.x - Pubmed citation
- 5. Choi SK, Lee S, Kim S et-al. A rare case of upper ureter rupture: ureteral perforation caused by urinary retention. Korean J Urol. 01;53 (2): 131-3. doi:10.4111/kju.2012.53.2.131 - Free text at pubmed - Pubmed citation
- 6. Stravodimos K, Adamakis I, Koutalellis G et-al. Spontaneous perforation of the ureter: clinical presentation and endourologic management. J. Endourol. 2008;22 (3): 479-84. doi:10.1089/end.2007.0196 - Pubmed citation