Acutely obstructing right ureteral calculus causing collecting system rupture

Case contributed by Dr Amro Omar

Presentation

Severe right flank pain since two days

Patient Data

Age: 60
Gender: Male

Non-enhanced study shows an obstructive calculus at the right ureterovesicular junction with free fluid (urinoma) in the perirenal space and the right paracolic gutter, reaching the pelvis.

Delayed phase shows contrast extravasation from the the right renal collecting system. The rupture is most probably in the right ureteropelvic junction / proximal ureter.

Incidentally noted are two adrenal adenomas lipid rich (measured <10 HU in the precontrast study) and multiple hypovascular cystic liver lesions.

Case Discussion

Urinomas (or uriniferous fluid collections) are usually found in the retroperitoneum, most commonly in the perirenal space

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Case Information

rID: 34727
Case created: 6th Mar 2015
Last edited: 18th Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

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