Forniceal rupture from obstructing ureteral stone
Persistent agonizing left flank pain.
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Mild left hydronephrosis due to an obstructing small left upper third ureteric stone measuring 6 mm.
Water attenuation fluid (10 - 15 HU) confined in the left perirenal space, more evident around its lower pole, is compatible with a rupture of a calyceal fornix in the kidney and urine extravasation / leak.
There is an additional lower calyceal stone measuring 12 mm.
Whilst contrast extravasation into a perinephric fluid collection in delayed excretory phases after IV contrast administration can confirm a forniceal rupture with urine leak, it may not be necessary if there is a classic appearance on a noncontrast study.