Ureteric injury post cesarean section

Case contributed by Fakhry Mahmoud Ebouda

Presentation

Post emergency cesarean section with high output intraperitoneal tube drainage. The C-section is preceded by 5 trials of vacuum delivery.

Patient Data

Age: 35
Gender: Female

IVU

Fluoroscopy

Contrast leakage and spillage is seen in the left side of pelvis in the region of lower third left ureter denoting a left ureteric injury.

Post repair of left ureteric injury with ureteric catheter seen in place.

Case Discussion

Ureteral injuries are known complication of gynecologic surgery. It is a common cause of medicolegal problems.

Ureteric injury post-gynecological procedure needs a high index of suspicion. Delay in diagnosis or inappropriate treatment lead to serious immediate and delayed complications.

A strong clinical suspicion is needed in order that the correct imaging investigation is undertaken - traditional or CT-IVU being the modalities of choice.

The case is courtesy of Dr/ AbdulWahab Saleh Urology Consultant, RCMC

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