Medicina Fluminensis, Vol. 60 No. 3, 2024.
Case report, case study
https://doi.org/10.21860/medflum2024_319219
Forniceal Rupture as a Result of Obstructive Uropathy – a Case Report
Alojzije Košić
orcid.org/0009-0003-9718-3885
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
*
Iva Žuža
; Klinički bolnički centar Rijeka, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Rijeka, Hrvatska
Dean Markić
; Klinički bolnički centar Rijeka, Klinika za urologiju, Rijeka, Hrvatska
* Corresponding author.
Abstract
Aim: To present a case of a renal forniceal rupture as a result of obstructive ureterolithiasis and to give insight into diagnostic and treatment methods of this acute state. Case report: A 34-year-old female patient was admitted to the emergency department for a recurrent left-sided flank pain. The percussion of the left kidney was positive, and blood analysis showed increased creatinine levels and decreased estimated glomerular filtration rate. Aditionally, urine analysis was positive for leukocyte esterase and hemoglobin. Abdominal ultrasound showed grade 2 hydronephrosis and fluid collection in the left perirenal space which indicated forniceal rupture. Non-contrast CT images obtained through abdomen and pelvis revealed obstructive stone in the ureter and perirenal fluid. Post-contrast CT images confirmed the presence of water attenuation fluid around the kidney consistent with a forniceal rupture and urine leak. The patient received analgesics and antibiotics. The Double J-stent and urinary catheter were used to decrease renal pressure and to reduce symptoms. With proper instructions, the patient went home after a successful recovery and regression of symptoms. Two months later, the patient underwent a successful ureteroscopy with a stone extraction. The postoperative course was uneventful. Conclusion: The clinical presentation of renal forniceal rupture is non-specific. The most common cause is obstruction caused by stones, and imaging confirms the diagnosis. Drainage of the urinary tract is the first step of treatment, which can be conservative and/or surgical.
Keywords
kidney; rupture; urinoma; urolithiasis
Hrčak ID:
319219
URI
Publication date:
1.9.2024.
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