Abstract
Background: Rupture of renal calyces with urinoma, mimicking acute abdomen, is an unusual condition that is mostly caused by distal ureteral stone. Case Presentation: Ultrasonographic evaluation showed right hydronephrosis in a woman who was admitted to our emergency department with persistent severe abdominal pain. A delayed contrast -enhanced computerized tomography (CT) was required to confirm the diagnosis of rupture in symptomatically worsening patient. Among various treatment options conservative treatment was preferred, the patient was recovered, and urinoma was resolved without any complication. Diagnosis and treatment options are discussed. Conclusion: A spontaneous rupture of the urinary system can mimic acute abdomen, and should always be considered in the differential diagnosis of a patient presenting complex symptoms after renal colic. If a definite diagnosis cannot be established by routine imaging modalities, delayed phase contrast- enhanced CT would be helpful in this regard. Conservative treatment with careful monitoring is an option with good results, thus it may obviate the need for surgical intervention in most of the patients.
Highlights
Spontaneous rupture of the renal calyx and urine extravasation with symptoms of acute abdominal pain is a rare condition
I report a case of spontaneous rupture of the renal calyx due to ureteral stone, and its etiology, diagnosis, and treatment options are discussed
An immediate ultrasonographic evaluation revealed right hydronephrosis associated with a 3 mm distal ureteral stone
Summary
Spontaneous rupture of the renal calyx and urine extravasation with symptoms of acute abdominal pain is a rare condition. The underlying pathophysiology of the rupture is the increased pressure in the renal pelvis exceeding the critical level of 20 to 77 mmHg1, 2. The frequent cause is a stone, mostly located at the distal part of the ureter followed by malignant extrinsic ureteric compression[3]. I report a case of spontaneous rupture of the renal calyx due to ureteral stone, and its etiology, diagnosis, and treatment options are discussed
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