Rupture Of Pelvis Research Articles

Life-threatening gross hematuria caused by giant renal artery branch aneurysm coexistent with artero-venous fistula leading to acute rupture of renal pelvis

Life-threatening gross hematuria caused by giant renal artery branch aneurysm coexistent with artero-venous fistula leading to acute rupture of renal pelvis

Hydronephrosis and pelvic rupture due to calculus with completely normal laboratory results

Both side pain and urinary system pathologies are common reasons for admission to emergency departments. Spontaneous renal pelvic rupture is also very rare. Existing renal anomalies and calculi also increase the risk of rupture. Here, we present a 50-year-old male case who developed unilateral renal pelvis rupture spontaneously without trauma.

Spontaneous renal pelvis rupture: a case report

Uro-Technology Journal Home About Guidelines Current Issue Archives Online First Special Issues Editorial Board Videos Submissions Home > Vol 7, No 4 (2023) > Pizzarello Download PDF Submit A Manuscript Table of contents Spontaneous renal pelvis rupture: a case report Javier Pizzarello, Luis Rico, Leandro Blas, Hernando Rios Pita Abstract Spontaneous renal pelvic rupture (SRPR) is a rare entity. Diagnosis is made by contrast-enhanced computed tomography or retrograde pyelography, and management may be active or conservative. We present the case of a 79-year-old woman who developed SRPR of the left kidney on the fifth postoperative day of a right laparoscopic nephroureterectomy with endoscopic bladder cuff resection. Active management was decided and a ureteral catheter was placed. Symptoms improved and the patient did not develop any complications during follow-up. This case report explores SRPR, a condition with traumatic and non-traumatic causes, including urethral calculi and congenital abnormalities. SRPR is the result of a sudden increase in intraluminal pressure, often exceeding 20–75 mmHg, causing tissue tearing at the weakest urinary tract point, the fornix. In this instance, the patient experienced contralateral renal pelvic rupture following nephroureterectomy with no apparent cause for elevated intrarenal pressure. We propose that bladder irritation after ureteral cuff resection induced spasms, triggering the rupture. Diagnostic challenges arise as initial symptoms mimic renal colic, later manifesting as a urinoma. Imaging techniques, such as ultrasonography and contrast-enhanced CT, aid in the diagnosis. Treatment options encompass ureteral stenting and conservative management, with the choice depending on the patient’s condition. This case underscores the significance of early recognition and management of SRPR, especially following nephroureterectomy. In conclusion, SRPR is an entity that requires immediate management. It is important to evaluate if there are any features that require active treatment.

Spontaneous rupture of the renal pelvis due to squamous cell carcinoma of the urinary bladder: a rare case

Bladder cancer is the fourth most common tumor in men and is usually diagnosed around the seventh decade of life. The predominant histological type is transitional cell carcinoma, while squamous cell carcinomas and adenocarcinomas are less common. Spontaneous rupture of the excretory system, an obstructive complication, is a rare occurrence and even more uncommon when caused by neoplasia. The aim of this article is to report the case of a male patient with spontaneous rupture of the pelvis due to squamous cell carcinoma of the bladder. With regard to renal pelvis rupture due to primary urinary tract obstruction, stone formation (lithiasis) is the most common cause, accounting for 50%, while neoplasia ranks fifth. As for the histological subtypes of the neoplasm, it is essential to note that transitional cell carcinoma is observed in 90% of cases.

Spigelian hernia in children: a case report and meta-analysis of the literature

Introduction. Spigelian hernia (SH) or hernia of the Linea semilunaris is an extremely rare disease in the pediatric practice. Though it is a congenital malformation, it is revealed and treated surgically mostly at the age of over 50.Clinical observation. A 6-month-old girl was surgically treated for SH at the Ilyinskaya Hospital. The child had been followed up since her birth for terminal hydronephrosis, complicated by the rupture of renal pelvis. At the age of 4 months, because of absent functions and recurrent infection in the urinary system, the child survived nephroureterectomy. On day 4 after surgery, the patient demonstrated signs of anxiety and pain. Ultrasound examination revealed a strangulated right-sided SH. The hernia was invaginated under ultrasound control. There were no SH relapses during the dynamic follow-up. At the age of 6 months, SH laparoscopic plasty with local tissues was made. There were no complications. There were no any signs of SH relapse for the following 3 months.Conclusions. The search in the literature sources showed that for over 90-year period only 95 cases of SH in children have been described. The article also describes SH direct and indirect signs, possible complications and options for surgical treatment. Laparoscopic SH correction was performed only in 4 cases in children aged 11 months and older. The case presented by the authors is the 5th SH laparoscopic correction in the world.

COVID-19 enfeksiyonu geçiren hastada böbrek pelvis rüpürünün eşlik ettiği spontan ciddi retroperitoneal kanama: Olgu sunum

Spontaneous rupture of the renal pelvis is a rarely encountered urological event that causes extravasation of urine. It often occurs as a result of increased intrapelvic pressure secondary to obstructions developed in the urinary system. Similarly spontaneous retroperitoneal hematoma is retroperitoneal hemorrhage that occurs without trauma or an underlying pathology. In this study, we present a case of spontaneous rupture of the renal pelvis that developed secondary to compression of the hematoma that occurred spontaneously in the retroperitoneum in a 63-year-old female patient who received anticoagulant therapy with the diagnosis of Covid-19 infection. In the light of this case, we would like to emphasize that widespread endothelial cell damage associated with Covid-19 infection may cause spontaneous severe retroperitenal bleeding and accompanying renal pelvis rupture. In which both the rarely encountered spontaneous rupture of the renal pelvis and spontaneous retroperitoneal bleeding are seen simultaneously in the same patient, is reporting for the first time in the literature. Keywords: anticoagulant treatment, COVID-19, renal pelvis rupture, retroperitoneal hematoma, urinary obstruction

A Retroperitoneal Fibrosis Case Presented with Spontaneous Rupture of Renal Pelvis

A Retroperitoneal Fibrosis Case Presented with Spontaneous Rupture of Renal Pelvis

Renal pelvic rupture: A case report of an unexpected cause.

IntroductionRenal pelvic rupture (RPR) is a rare condition, that is most usually caused by obstructive calculi.In another hand, primal ureteral tumors are also uncommon, with only a few cases reporting their involvement in a RPR.Presentation of caseWe report a case with a multimodality discussion of an ureteral tumor, with a spontaneous renal pelvic rupture (RPR) forming a large retrorenal urohematoma.DiscussionOnly few series reported the subject of RPR in the English literature. Only some single cases reported the causality of urinary tract tumors in RPR.RPR is an imaging based diagnosis. Herein, upper urinary tract tumors show a variable appearances at imaging.ConclusionBy reporting this case, we highlight the role of both computed tomography (CT) and magnetic resonance (MR) imaging in the diagnosis of the RPR and their accuracy in the detection of the ureteral tumor. We also consolidate the effectiveness of the conservative attitude in the management of the RPR.

Spontanous Rupture of Renal Pelvis Due to Bladder Globe

Spontanous Rupture of Renal Pelvis Due to Bladder Globe

Incidental misplacement of a percutaneous nephrostomy tube in the inferior vena cava

Introduction. An isolated renal pelvis rupture is a rare type of blunt renal trauma that can occur mostly in patients with pre-existing hydronephrosis due to different causes. We presented a patient with the misplacement of a percutaneous nephrostomy tube during the treatment of isolated renal pelvis rupture in a patient with pre-existing hydronephrosis caused by post-irradiation ureteral stricture. Case report. A 36-year-old woman was referred to our institution by her gynaecologist for the treatment of a retroperitoneal urinoma. She had completed the irradiation treatment with concurrent cisplatin chemotherapy for a uterine malignancy one year ago. A computed tomography scan showed an isolated rupture of the left renal pelvis with the pre-existing hydronephrosis. A nephrostomy catheter was misplaced in the inferior vena cava during the percutaneous urinary drainage attempt. The patient underwent a laparotomy, renal pelvis suture and ureteroneocystostomy with an indwelling double pigtail stent. The percutaneous nephrostomy was removed during the same surgical procedure. Conclusion. Inadvertent injury of vascular structures is a possible complication of percutaneous nephrostomy under ultrasound guidance. It may have been possible to avoid the reported complication if the dilation of the nephrostomy tract over the guidewire had been performed under contrast-enhanced X-ray fluoroscopy.

Spontan Renal Pelvis Ruptürü: Nadir Görülen Bir Olgu Sunumu

Renal urinary leak and associated urinoma usually develop secondary to renal trauma. Spontaneous rupture of the renal collecting system is not expected to occur in a healthy kidney. Here we present differential diagnosis and treatment of a case of spontaneous renal pelvic rupture.

Bladder neck reconstruction in girls\u2019 pelvic fracture bladder neck avulsion and urethral rupture

BackgroundGirls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap.MethodsWe retrospectively analysed data of 5 girls with pelvic fracture bladder neck avulsion and urethral rupture admitted to our institution from July 2017 to October 2019. They all came to our institution with a suprapubic tube. Patients’ trauma was all initially treated at other hospitals, 4 had suprapubic cystotomy and 1 had urethral realignment. One girl also had three other urethroplasties at other hospitals. We took pubectomy, posterior urethroplasty and bladder neck reconstruction with anterior bladder wall flap in these 5 girls. Post-operative assessments included voiding cystourethrography, uroflowmetry and urethroscopy after urethral catheter removal. Verbal consent to participate was obtained from the parent or legal guardian of the children.ResultsOperation time ranged from 120 to 180 min. Follow-up time is 12 to 27 months. Uroflowmetry showed that maximum urine flow rate improved significantly. Cystourethrography indicated good continuity of the urethra. Two girls had urinary incontinence postoperatively but were continent 3 months later. One patient developed vesical-abdominal fistula and got repaired by surgery 6 months later. She was continent ever since. Other complications were not observed during the follow-up period.ConclusionsOur method of bladder neck reconstruction using bladder flap as a patch is feasible and provides good continence, especially for those with serious bladder neck avulsion and urethral rupture caused by extensive trauma and those who had posttraumatic urethral distraction needed second repair.

Spontaneous bilateral renal pelvis rupture during CT in the absence of urinary tract obstruction: case report

BackgroundAtraumatic renal pelvis rupture without pre-existing renal or ureteric pathology is an uncommon event. It is reported in the setting of acute urinary tract obstruction, most often secondary to ureteric calculi. Typical symptoms include acute flank pain and nausea, mimicking pyelonephritis or other causes of acute abdomen. Spontaneous rupture occurring bilaterally without identifiable urinary tract obstruction is exceedingly rare, and has yet to be reported in current English literature. Possible contributing pathophysiological mechanisms can be postulated from reported cases of rupture with observed obstruction.Case presentationA 58-year-old woman undergoing multiphasic computed tomography (CT) for evaluation of asymptomatic microscopic haematuria developed on-table bilateral renal pelvis rupture seen only after contrast administration, on the delayed phase. There was no significant past medical history of note. The patient remained asymptomatic throughout and after the study, and was managed conservatively. Follow-up radiographical imaging over a month showed resolution of urinoma and no further contrast extravasation. No complications or recurrence was subsequently noted.ConclusionsSpontaneous rupture of the renal pelvis can be a rare complication of intravenous contrast administration even in cases without identifiable urinary tract obstruction, and it can occur bilaterally. Cases can uncommonly be asymptomatic but typical symptoms should prompt evaluation of the kidneys, particularly when they are not included in the initial study or no delayed phase is protocolled. Interval imaging for resolution of urinoma and contrast extravasation is clinically relevant to monitor for and avoid infective sequelae.

Local intra-gestational sac methotrexate injection followed by dilation and curettage in treating cesarean scar pregnancy.

To assess the safety and efficacy of local intra-gestational sac methotrexate injection followed by dilation and curettage (D&C) in treating cesarean scar pregnancies (CSP). Medical records of CSP patients treated with local intra-gestational sac methotrexate injection followed by dilation and curettage were analyzed at the Maternal and Child Hospital of Guangxi Zhuang Autonomous Region, China. Thirty-one patients were included in this study. The mean gestational age, sac diameter and thickness of the uterine scar were 49.6±7.7days, 1.8±0.6cm and 0.30±0.15cm, respectively. The median pretreatment serum β-human chorionic gonadotropin (β-HCG) level was 40,887mIU/mL, with the 25th and 75th percentiles at 19,852 and 74,552, respectively. The median blood loss during D&C was 20mL with the 25th and 75th percentiles at 10mL and 50mL. Following D&C, a Foley's balloon catheter compression was implanted in 26 (83.9%) patients due to active uterine bleeding. All patients had a β-HCG regression time of ≤ 4weeks after D&C. While 30 patients (96.8%) had a uterine recovery time of ≤ 4weeks, and 29 patients (93.5%) had resumption of menstruation of less than 6weeks. Three patients (9.7%) had complications. One of them suffered from massive vaginal bleeding and underwent s blood transfusion. There were no other complications, such as pelvic infection and uterine rupture during the procedures. And no patient was converted to surgical resection or uterine artery embolization. Overall, 30 patients (96.8%) were treated successfully. Local intra-gestational sac methotrexate injection followed by D&C with the aid of a Foley's balloon catheter compression appears to be a safe and effective treatment for CSP. Further randomized controlled trials are suggested to confirm these findings.

Paraovarian cyst as the cause of uterine prolapse

Paraovarian cysts originate from the mesothelium and are presumed to be remnants of M?llerian or Wolffian ducts. In majority of cases they are found to be 10-80 mm in diameter and do not cause any symptoms. Paraovarian cysts can be found unexpectedly during an operation or on ultrasound examination performed for other reasons. They are most freequently discovered on ultrasound examination. However, due to the proximity of the ovary for which cystic formations are not rare, the diagnosis of these lesions can be a challenge. They are mostly asymptomatic and only large lesions (?20 cm in diameter) become symptomatic. Although these are mostly benign tumors, in rare cases they can become borderline or true malignancies. Most paraovarian cysts are found in the third and fourth decade of life. Paraovarian cyst complications include: compression of the surrounding structures of the pelvis minor and abdomen, pelvic pain, cyst torsion and rupture. Except for the already mensioned complications available literature has so far failed to show cases of uterine prolapse caused by an increase of intra-abdominal pressure due to the expansive growth of giant paraovarian cystic formation.

Hydrocolloid Membrane Dressing in Shearing Injuries in the Distal Part of the Pelvic Limbs in Dogs

Background: Shearing wounds on the limbs of dogs usually affect the regions distally from the radiocarpal joint at the thoracic limb and from the tibiotarsal joint at the pelvic limb. The tissue coverage and re-epithelialization of the injured region are important factors that should be considered in the definitive surgical treatment. The hydrocolloid membrane promotes selective autolytic debridement and accelerates the formation of granulation tissue and epithelialization. The present study aims to describe the treatment with hydrocolloid membrane dressing of three cases of shearing wounds with concomitant orthopedic injuries in the pelvic limbs of dogs.Case: Three dogs with pelvic limb injuries after vehicular trauma were selected for treatment. Two patients had shearing lesions on the medial aspect of the pelvic limb with exposure of the tibia and fibula, the talus and the tibiotarsal joint, associated with bone loss on the medial surface of the limb and rupture of the medial collateral ligament of the tarsus. Another patient had a shearing wound on the dorsal surface of the distal region of the pelvic limb, with injury of the digital extensor tendons and bone exposure of the second and third metatarsals. Initially, the surgical debridement of the lesion was performed and during the first five days after trauma the wound was cleansed with chlorhexidine solution and topical application of crystallized sugar daily. In this initial period a dry adherent dressing was used on the lesions, without bandages for immobilization of the pelvic limb. In all dogs, the hydrocolloid membrane was applied from the sixth day after initial wound management. Immediately after the application of the hydrocolloid membrane, temporary immobilization of the affected pelvic limb with a padded Robert Jones bandage was performed. The first changes of the hydrocolloid membranes were performed after five days of their use. Subsequently, the membranes changes became more spaced and were performed within a period between 7 to 10 days. After wound repair, in one of the dogs with a shearing injury in the medial surface of the pelvic limb, the rupture of the medial collateral ligament was surgically treated with the use of anchor screws and nylon thread for the ligament reconstruction. The other dog presented with lesion in the medial surface of the pelvic limb and collateral ligament rupture was not submitted to late orthopedic surgical treatment. The latter was clinically managed and developed valgus deviation of the affected pelvic limb, but with functional use of the limb. The dog with a shearing lesion on the dorsal surface of the pelvic limb and injury to the extensor tendons was managed conservatively with use of orthosis and, after 45 days of initial trauma, the dog showed a functional lameness and absence of pain in the affected limb.Discussion: In all animals, the hydrocolloid membrane was applied on the wound from the sixth day after the initial lesion treatment. As the wound was healing the hydrocolloid dressing was changed in a more spaced period and this management allowed the proper tissue healing without complications. The wound treatment with dressing was aided by the application of temporary limb immobilization with padded bandage, until a late orthopedic procedure was performed or a final clinical resolution occurred. In general, the shearing wounds healed in a period ranging from 28 to 38 days. In conclusion, the use of the hydrocolloid membrane dressing associated with limb immobilization was an effective method for treatment of patients with shearing wounds, allowing proper healing of the affected tissues and good recovery of the limb function. The hydrocolloid membrane has the main benefits to allow the spaced changes of the dressings and the ability to stimulate the rapid healing of the wound.

Diagnosis and treatment of spontaneous rupture of renal pelvis caused by pelviureteric junction obstruction in infants

Objective To analyze the clinical features of spontaneous rupture of the renal pelvis (SRRP) in infants caused by UPJO. Methods A retrospective analysis of 7 cases of SRRP in infants caused by UPJO in our hospital from October 2013 to October 2018 was performed. All the patients included 5 males and 2 females. The average age was(12.0±6.1) months(ranging 2 days-25 months). 3 cases suffered renal rupture in left side and 4 cases suffered renal rupture in right side. 2 cases had grade Ⅲ hydronephrosis and 5 cases had grade Ⅳ hydronephrosis. Other symptoms included fever in 4 cases, digestive symptoms in 3 cases, oliguria in 2. 7 cases were revealed RBC(+ + + )with urinary occult blood positive in urine test. 6 cases were found the white blood cells in urine was more than 8/μl. 3 cases had the elevated blood C-reactive protein.3 cases suffered with renal function insufficiency, which the creatinine was more than 110 μmol/L. The 2 cases of urinary extravasation was found in the posterior abdominal cavity and 2 in posterior abdominal cavity and abdominal cavity by CT enhanced scan. 4 cases performed open pyeloplasty, nephrostomy and perirenal drainage.2 cases performed pyeloplasty, nephrostomy, abdominal and perirenal drainage. 1 case performed perirenal drainage and retrograde indwelling Double-J stents. Results All operation performed successfully. The median operation time was 84 min (ranging 45-90 min). The estimate blood loss was 15 ml (ranging 10-35 ml)without any transfusion. The median time of postoperative perirenal drainage tube was 3 d (ranging 2-5 d), The median time of the abdominal drainage tube was 5 d (ranging 3-7 d), the median time of nephrostomy was 12 d (ranging 10-14 d). The median hospital stay was 14 d (ranging 10-21 d). The median follow-up was 18 months (ranging 3-36 months). One performed the second stage pyeloplasty after double-J stents removed, and the renal function gradually recovered. Conclusions The SRRP in infants caused by UPJO is rare and easily misdiagnosed. The degree of hydronephrosis and inflammation may be important factors affecting the spontaneous rupture of pediatric renal pelvis. When it occurs, it requires active intervention by the operation, while treating the stenosis of the UPJ and draining the extravasation of urine. Key words: Hydronephrosis; Spontaneous rupture of the renal pelvis; Ureteropelvic junction obstruction

Spontaneous Rupture of Renal Pelvis: A Rare Complication of Obstructive Ureteral Stone

Spontaneous Rupture of Renal Pelvis: A Rare Complication of Obstructive Ureteral Stone

A Case of Rectal Cancer Presented with Renal Pelvic Rupture Associated with Ureteral Obstruction Caused by Extramural Cancer Deposits without Lymph Node Structure (EX)

A Case of Rectal Cancer Presented with Renal Pelvic Rupture Associated with Ureteral Obstruction Caused by Extramural Cancer Deposits without Lymph Node Structure (EX)

Bilateral rupture of the renal pelvis as a complication of placental abruption in multiparous female

A non-traumatic rupture of renal pelvis during pregnancy is an extremely rare complication. The authors report a case of bilateral rupture of the renal pelvis in a multiparous female who underwent emergency cesarean section during vaginal birth after previous cesarean section, owing to abrupt and massive vaginal bleeding and prolonged fetal late deceleration. During surgery, a disproportionately enlarged uterus was noted and postoperatively severe oliguria was complicated with a sustainable amount of packed RBCs transfusion. CT revealed extravasation of contrast media around bilateral perinephric space. Treatment course and review of the cause of renal pelvis rupture is discussed along with literature study.