Urinoma seconday to calyceal rupture - chronic ureteric obstruction

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Acute on chronic renal failure with sepsis in blood and urine

Patient Data

Age: 80 years
Gender: Male

Obstructed (hydronephrotic) upper left ureter due to a large calculus. Large fluid collection in the left side of pelvis in the region of the ilio-psoas muscle with a tubular connection to a lower pole calyx of the left kidney. Note this fluid collection is of the same density as the obstructed collecting system and not surrounded by inflammatory change in the adjacent fat.

Case Discussion

Acute calyceal rupture due to ureteric obstruction is uncommon but well recognized. It is usually very painful thus presents early. In this case there is chronic ureteric obstruction with development of a urinoma communicating via a lower pole calyx. This collection will only resolve once the ureteric obstruction is relieved.

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