Presentation
High speed MVA. Increasing right sided abdominal pain and distension 8 hours post presentation with oliguria prompted repeat CT.
Patient Data
Bilateral upper pole renal infarcts, likely due to traumatic small vessel dissection. Right-sided perinephric fluid and dilated proximal ureter raise concern for ureteric rupture.
Extensive extravasation of contrast into the right perinephric space and pelvis is seen. No contrast is seen the distal right ureter. Findings are in keeping with proximal ureteric rupture.
Intraoperative fluoroscopy demonstrates extravasation of contrast from the proximal ureter, confirming the diagnosis of transection of the right proximal ureter.
Case Discussion
This is a case of traumatic ureteric rupture from a high-speed motor vehicle accident, confirmed by ureteroscopy and intraoperative fluoroscopy. The patient was transferred to a tertiary center for percutaneous nephrostomy and definitive urological management.