Spontaneous Rupture of the Urinary Collecting System During Computed Tomography Scan
Keywords:Rupture, Spontaneous, Tomography, X-Ray Computed, Urinary Tract
Spontaneous rupture of the urinary tract is a rare entity. It probably occurs due to increased pressure in the urinary tract and usually is associated with obstructive factors. We report a case of a patient who presented rupture of the upper urinary tract during computed tomography without any associated obstructive factor. We believe that this happened due to the distension of the urinary system in function of contrast infusion. Our case is interesting because of the unusual etiology of this clinical entity and alerts us to the risk of high intraluminal pressures during urological endoscopic procedures and image exams. In addition, curiously the patient presented spontaneous resolution without performing the treatment suggested in the literature, which is the placement of a double-J catheter.
2. Yanaral F, Ozkan A, Cilesiz NC, Nuhoglu B. Spontaneous rupture of the renal pelvis due to obstruction of pelviureteric junction by renal stone: A case report and review of the literature. Urol Ann. 2017;9:293–5. doi:
3. Zhu X, Li J, Ding F. Two case reports and literature review of spontaneous renal rupture after ureterscope assisted holmium laser lithotripsy. Clin Urol. 2015;3:261–2.
4. Ashebu SD, Elshebiny YH, Dahniya MH. Spontaneous rupture of the renal pelvis. Australas Radiol. 2000;44:125–7.
5. Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR. Urine leaks and urinomas: Diagnosis and imaging-guided intervention. Radiographics. 2003;23:1133–47. doi: 10.1148/rg.235035029
6. Paajanen H, Kettunen J, Tainio H, Jauhiainen K. Spontaneous peripelvic extravasation of urine as a cause of acute abdomen. Scand J Urol Nephrol. 1993;27:333-6.
7. Koga S, Arakaki Y, Matsuoka M, Ohyama C. Spontaneous peripelvic extravasation of urine. Int Urol Nephrol. 1992;24:465-9.
8. El-Boghdadly SA. Spontaneous rupture of the ureter proximal to ureteric stone. J R Soc Med. 1985;78:255-7.
9. Gershman B, Kulkarni N, Sahani DV, Eisner BH. Causes of renal forniceal rupture. BJU Int. 2011;108:1909–11. doi: 10.1111/j.1464-410X.2011.10164.x.
10. Kalafatis P, Zougkas K, Petas A. Primary ureterocopic treatment for obstructive ureteral stone causing fornix rupture. Int J Urol. 2004;11: 1058-64. doi: 10.1111/j.1442-2042.2004.00949.x
11. Sallami S, Ben Rhouma S, Rebai S, Gargouri MM, Horchani A. Spontaneous rupture of the upper urinary tract caused by ureteral calculi: effectiveness of primary ureteroscopic treatment. UroToday Int J. 2009;2: 5784-92.
12. Cooke GM, Bartucz JP. Spontaneous extravasation of contrast medium during intravenous urography - Report of fourteen cases and a review of the literature. Clin Radiol.1974; 25: 87-93.
13. Gokkaya CS, Baykam MM, Yahsı S, Bulut S, Aktas BK, Memı A. Spontaneous fornix rupture due to obstructive ureteral stone. Erciyes Med J. 2014;36:91-3.
14. You JS, Chung YE, Lee JY, Lee HJ, Chung TN, Park YS, et al. The spontaneous rupture of the renal fornix caused by obstructive nephropathy. J Emerg Med. 2012;43:488–9. doi: 10.1016/j.jemermed.2011.06.126.
15. Silverman SG, Leyendecker JR, Amis ES Jr. What is the current role of CT urography and MR urography in the evaluation of the urinary tract? Radiology. 2009;250:309–23. doi: 10.1148/radiol.2502080534.
16. Tan S, Arifoğ lu M, Ipek A, Onen E. Ozturk. H. The importance of gray scale and color Doppler ultrasonography in the diagnosis of spontaneous renal pelvis rupture: case report. Turk J Urol. 2010;36:434-7.
17. Kalafatis P, Zougkas K, Petas A. Primary ureteroscopic treatment for obstructive ureteral stone-causing fornix rupture. Int J Urol. 2004;11:1058–64. doi: 10.1111/j.1442-2042.2004.00949.x.