Spontaneous rupture of the ureter

Spontaneous rupture of the ureter is a rare complication of acute ureteric obstruction at whichwhen there is non-traumatic leakage of the urine from the ureter. The diagnosis is made by contrast studies (CTU or IVU) where there is a contrast leakage around the ureter through the retroperitoneal space and a visible cause of acute distal ureteric obstruction. It is usually secondary to an obstructing ureteric stone. However, it can occur due to other cases ascauses of obstruction by a tumore.g. tumour. Urine extravasation appears as a fluid collection or stranding inon non-contrast basisimages. It is well demonstrated inon delayed excretory contrast studies ase.g. IVU or CT urography. Extravasation can resolve spontaneously after relieving obstruction or can progress to form a urinoma.

Non-contrast CT scan shows left upper third ureteric stone measuring around 0.4~0.5 x 0.5.4 cm. This is associated with a dilated collecting system (grade II hydronephrosis) as well as theand proximal ureterhydroureter down to the stone level which showedwith associated ureteric mural thickening withand permeation of the periureteric fat.

The delayed scans showed extravasation of the excreted contrast around the left ureter creating a non-walled retroperitoneal collection with feathery irregularities along the ventral surface of the renal pelvis, with tracking of the contrast from the perirenal space, along the anterior border of left psoas muscle tilluntil it reaches the left side of the pelvis.