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Renal forniceal rupture

Case contributed by Amro Omar
Diagnosis almost certain

Presentation

Severe right flank pain since two days.

Patient Data

Age: 60 years
Gender: Male
ct

Non-enhanced series shows an obstructive calculus at the right ureterovesicular junction with free fluid in the perirenal space and the right paracolic gutter extending inferiorly to the pelvis.

Delayed phase series shows contrast extravasation from the the right renal collecting system, indicative of rupture of the collecting system. The rupture is probably located at the right ureteropelvic junction or 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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