Incomplete ureteric injury following abdominal hysterectomy

Case contributed by Dr Chris O'Donnell

Presentation

Severe abdominal pain in the days following abdominal hysterectomy.

Patient Data

Age: 35 years
Gender: Female

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).

Case Discussion

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.

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Case information

rID: 36562
Published: 29th Apr 2015
Last edited: 10th Jul 2019
Inclusion in quiz mode: Excluded

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