Extra-renal rupture of a cortical cyst with subsequent perinephric haematoma
Patient comes to the emergency department complaining of severe right flank pain. He reports that the pain began approximately 4 hours ago. No history about trauma or prior drug use.
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Three phase contrast enhanced CT scan shows antero-superior displacement of the right kidney by high density perinephric hematoma associated with multiple(bilateral) cortical cysts.There is no evidence of active contrast extravasation. No contrast within the perinephric collection on the excretory phase images to suggest a urinoma. There is also abdominal free fluid. The ruptured cyst is clearly delineated in the upper pole of the right kidney (arrow)
Beacuse there is no evidence of a distinct mass whitin the renal paranchyma,the most probable cause is, extra renal rupture of a simple cyst.