Ureteral injury due to oncologic pelvic surgery

Case contributed by Dr Bruno Di Muzio

Presentation

Patient developed a large left flank collection after large oncologic pelvic surgery that removed uterus, adnexa and part of colon. No other symptoms. The collection was drained percutaneously (images of procedure not available) and confirmed as urinoma.

Patient Data

Age: 65
Gender: Female
CT

CT Abdomen and pelvis

CT scan shows a small fluid collection next to left distal ureter, near where it crosses the iliac vessels, and a mild left ureterohydronephrosis. On the delayed scan its possible to confirm a visible small injury of 2.5 mm that communicate the ureter to this fluid collection and continues with drained area (urinoma). 

Annotated image

CT scan shows a small fluid collection next to left distal ureter, near where it crosses the iliac vessels, and a mild left ureterohydronephrosis. On the delayed scan its possible to confirm a visible small injury of 2.5 mm that communicate the ureter to this fluid collection and continues with drained area. 

Case Discussion

The CT confirms a iatrogenic left ureteral injury.

It is known that the risk of injury is significantly higher in surgeries involving invasive cancer, like in this patient. 

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Case information

rID: 30287
Case created: 31st Jul 2014
Last edited: 10th Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

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