Presentation
Severe right loin pain.
Patient Data
Hyperdense stone is seen at the middle part of the right ureter, with moderate proximal hydroureter and hydronephrosis. It measures about 17 mm and has a density of about 435 HFU. A large amount of fluid collection is seen mainly at perirenal space tracking to the pelvis region.
Delayed images reveal contrast extravasation with evidence of a connection between this fluid and the middle calyx indicating a urine leakage picture consistent with urinoma.
Case Discussion
A 30-year-old male with a known 17 mm right middle third ureteric stone returned to the emergency department (ED) 60 days after initial diagnosis for severe right flank pain and nausea. Vital signs were within normal limits, laboratory tests were unremarkable, CT with contrast was performed and revealed contrast extravasation secondary to post-obstructive middle calyceal rupture picture consistent with urinoma.
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