Abdominal CT before and after contrast injection
A non-contrast Computed Tomography (NECT) of the abdomen was performed which showed two 2–3 mm stones in the pelvic part of the left ureter, near the meatus with free fluid in the left retroperitoneum, suggestive of a perforation of the left collecting system. A delayed scan was performed to achieve a CT urogram (CTU). This confirmed extravasation of contrast medium around the left ureter, the rupture being at the lumbar level of the ureter. Both kidneys contain multiple stones.
Note decreased enhancement of the left kidney, best seen on the nephrographic (parenchymal) phase.
Coronal maximum intensity projection nicely shows the contrast material leak from the ureter at the lumbar level.