Presentation
Known TCC bladder. Now left loin pain and fever. ? obstructed, infected kidney.
Patient Data
Swollen left kidney with thickening of perinephric fat and a fluid collection anterior to the renal pelvis that fills with contrast from the renal pelvis over time consistent with a urinoma. Dilated left renal pelvis and ureter to the bladder where there is a large mural mass obstructing the left ureteric orifice causing the renal pelvis to rupture. Normal right kidney. No stone in the left ureter.
Case Discussion
Rupture of the renal pelvis occurs either as a result of trauma or acute ureteric obstruction. This obstruction is usually a calculus but in this case is a bladder TCC. That is unusual as the obstruction with tumor tends to be slowly progressive.