Incomplete spontaneous ureteral disruption - Case report

Abstract

Background. The aim of the authors was to present the case of spontaneous partial ureteral rupture during a renal colic, caused by an anorganic concrement in the proximal part of the left ureter, at the level of the transverse processus of L3.

Case report. On the excretory urography imaging, the dilatation of the canal system, cups, necks and pyelon, was observed. At the level of the pyeloureteric passage, the contrast medium was leaking. The leakage was found to be extending along the psoas muscle to the pelvis. On the transversal CT imaging scans, the contrast medium was seen along the medial and dorsal part of the perirenal space, and in the distal part, along the psoas muscle to the pelvis. The ureter was imaged from the pyeloureterical rupture to the site of the concrement. No signs of the damage of the renal parenchyma or perirenal bleeding were detected. During surgery, the site of the rupture was found and also a lot of the perirenal and periureteral liquid. After the extraction of the concrement, the suture of the rupture was made. Postoperative urography and CT showed a normal ureteral image.

Conclusions. At the spontaneous partial disruption of the ureter, the contrast medium is still seen in the ureter, distally from the site of the rupture and as extravasation along the psoas muscle.