Abstract
Introduction
Spontaneous ureteral rupture is defined as non-traumatic urinary leakage from the
ureter. This is a diagnosis that, although uncommon, is important for emergency physicians
to know about. The literature is relatively sparse.
Materials and Methods
This was a retrospective review of patients who were diagnosed with spontaneous ureteral
rupture. From 2006 to 2012, 18 patients were diagnosed by radiography (computed tomography
or intravenous urogram) with spontaneous ureteral rupture. These cases all showed
extravasation of the contrast outside the excretory system. We evaluated underlying
causes, diagnostic and therapeutic procedures, and outcomes.
Results
There were 9 men and 9 women with a median age of 59 years (range, 22-82 years). In
56% of patients, a ureteral stone was the cause; in 17% of, a ureteral stricture;
in 1 patient, a ureteral tumor; and in the remaining 22%, no cause was identified.
In 13 patients (72.2%), primary ureteroscopy to place D-J stents was performed. The
average duration of ureteral catheter stenting was 21 days (range, 8-45 days). The
other 5 patients (27.8%) were managed conservatively with antibiotic treatment and
the outcome was good.
Conclusions
Ureteral stones most commonly cause spontaneous ureteral rupture. In our experience,
most patients received ureteroscopy and Double-J stenting. Conservative management
with antibiotics also had good outcomes. Most patients had sudden onset of abdominal
or flank pain. Spontaneous ureteral rupture should be kept in the differential diagnosis
of patients with acute abdominal or flank pain in the emergency department.
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Article Info
Publication History
Published online: March 31, 2014
Accepted:
March 21,
2014
Received in revised form:
March 18,
2014
Received:
February 16,
2014
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
