Presentation
Right ureteric colic
Patient Data
Age: 70 years
Gender: Male
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- obstructive right VUJ calculus
- dilated right renal pelvicalyceal system as well as entire ureter with periureteric free fluid
- circumscribed fluid in the perirenal space associated with thickening of anterior and posterior pararenal fascia with fluid tracking inferiorly along the iliospoas muscle
- associated fluid along ascending colon and right paracolic gutter
- exophytic right renal cyst
Case Discussion
Perinephric fluid collection in the presence of ureteric obstruction indicates urinary leak due to a ruptured collecting system. High pressure can be generated if the patient is well-hydrated and kidney function is normal.
Excretory phase CT IVU is not necessary to confirm the diagnosis as the appearances are typical.
Depending on the volume of leaked urine, fluid may track inferiorly along the iliopsoas muscle or even medially along renal vessels into the contralateral perirenal space.