Presentation
Patient attends hospital one most following an elective hysterectomy and BSO, with a contuined feeling of a watery perineal discharge.
Patient Data
Left duplex collecting system, which unites into a single ureter in the distal third.
A contrast filled structure in keeping with the vaginal vault, posterior the contrast filled urinary bladder, is evident in the pelvis. A tract extends from the ureter directly into the vaginal vault with contrast entering the posterior aspect of the vault, in keeping with a vagino-ureteric fistula.
Image 1: The RED arrows indicate the site where the ureter fistulates with the vaginal vault.
Image 2: C = catheter B = bladder V = vaginal vault ( which contains contrast )
Case Discussion
A beautiful example of the role of CT-IVU in assessing the urinary tract. The CT-IVU adds anatomical value over and above a traditional IVU or fluroscopic studies.
The fistula between the ureter and vaginal vault if well illustrated, this being a complication of surgery.