Incomplete ureteric injury following abdominal hysterectomy
Severe abdominal pain in the days following abdominal hysterectomy.
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Leak of contrast from the distal left ureter (arrow) although contrast passes beyond the point of leak into the distal ureter. No hydronephrosis. Free fluid in the pelvis represents urine (urinoma).
Ureteric injury is a well recognized complication of hysterectomy. Diagnosis requires correct CT technique i.e. delayed post contrast scanning. It is important for the treating surgeon to know the site of leak and if it is a complete or incomplete injury. If complete the patient will require nephrostomy and/or open surgical intervention. If incomplete, the urologist will attempt retrograde stenting under cystoscopic control.