台中榮民總醫院埔里分院 外科部 泌尿科1
A 30 min post-contrast KUB after enhanced abdominal CT for presentation of fornical urine leakage
Tsung-Wei Wang 1, Jia-Long Guo 1 , Jyun-Yan He 1
Division of Urology, Departments of Surgery, Puli Branch, Taichung Veterans General Hospital 1
Nontraumatic rupture of the urinary collecting system associated with perinephric or retroperitoneal extravasation of the urine is an unusual condition. Perforation could occur usually at the fornices and upper ureter. It may lead to several serious consequences including urinoma, abscess formation, urosepsis, infection, and subsequent irreversible renal impairment.
Materials and Methods:
We report a case of a 63-year-old woman who presented at the emergency department of our institution with severe left lower quadrant abdominal pain. Due to symptomatology worsening and history with sigmoid diverticulum, complete laboratory evaluation was performed and the patient underwent abdominal contrast enhanced computed tomography( CT) evaluation which showed multiple sigmoid diverticulum without fat stranding and no contrast agent extravasation outside the excretory system with evidence of left upper ureteral calculi and fluid accumulated around the left Gerota’s fascia region. A 30 min post-contrast KUB film after enhanced abdominal CT was taken as intravenous urogram( IVU), which showed contrast agent extravasation outside the excretory system without any evidence of ureteral calculi at basal acquisition.
Ureteroscopy with double-J stent placement was arranged and performed smoothly. Its removal was performed 8 weeks later.
This report present visualization of fornical urine leakage in post-contrast KUB after enhanced abdominal CT. Timely post-contrast KUB gets more clues in clinical differential diagnosis of acute abdomen.