Renal trauma in pregnancy

Case contributed by Craig Hacking


MVA. Abdominal pain and tenderness. Positive seat belt sign. 20 weeks pregnant. Bedside ultrasound showing IUFD.

Patient Data

Age: 25 years
Gender: Female
  • single intrauterine gestation, fetus and uterus appear intact. Heterogenous enhancement of the placenta.
  • right-sided retroperitoneal hemorrhage extending into the pelvis
  • small volume of pelvic free fluid
  • right proximal ureteric dilatation and wall hyperdensity suggestive of injury, normal enhancement of the right kidney with no parenchymal injury detected
  • small right renal artery aneurysm
  • subcut fat stranding in keeping with the seat belt sign

CT urogram


Large volume of contrast extravasation in the right retroperitoneum, from a renal pelvis laceration extending into the PUJ.

Case Discussion

The patient was treated with ureteric stenting and recovered well.

Renal collecting system injury is at higher risk in pregnancy due to the physiological hydronephrosis and hydroureter from the gravid uterus.

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