Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report

Q4 Medicine

Trauma Case Reports Pub Date : 2025-07-09 DOI:10.1016/j.tcr.2025.101220

Yukiko Asanuma , Motoo Fujita , Tomomi Sato , Takuma Sato , Shigeki Kushimoto

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引用次数: 0

Abstract

Back ground

Renal pelvis rupture due to trauma is commonly diagnosed in an excretory phase CT scan, which is not be applied in substantial proportion of trauma patients during initial evaluation. Since renal pelvis rupture has no specific findings, there is no clear indication to perform an excretory phase CT scan in the evaluation of trauma patients. We experienced a case presented with low-density fluid accumulation around kidney on plain CT imaging, subsequently diagnoses as having isolated renal pelvis injury.

Case presentation

68-year-old male fell from the second floor and referred to our institution. He had pain in his left buttock with a subcutaneous hematoma. He presented as blood pressure of 155 mmHg, heart rate of 145 beats/min, and blood test showed no specific abnormalities. Plain CT showed fluid accumulation around the left kidney, and following a contrast-enhanced CT scan at equilibrium phase showed no urinary extravasation. On the 4th hospital day, he complained of worsening back pain, and excretion phase of contrast-enhanced CT revealed left renal pelvic rupture. We placed a double-J ureteral stent for urinary drainage. Thereafter, disappearance of urinary extravasation without ureteral stricture was confirmed.

Conclusion

In patients with blunt trauma, perirenal effusion collection inconsistent with hemorrhage on CT imaging could be considered as a sign of isolated renal pelvic rupture.

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钝性创伤引起的孤立性肾盂破裂，在初始CT上表现为肾周围低密度液体积聚1例

背景：由于创伤引起的肾盂破裂通常在排泄期CT扫描中诊断，在初步评估时，这并不适用于相当比例的创伤患者。由于肾盂破裂没有明确的表现，在评估创伤患者时进行排泄期CT扫描没有明确的适应症。我们经历了一个病例，在CT平扫上表现为肾周围低密度液体积聚，随后诊断为孤立性肾盂损伤。病例介绍：68岁男性从二楼坠落，转诊至本机构。他左臀部疼痛并伴有皮下血肿。血压155 mmHg，心率145次/分，血液检查未见特殊异常。CT平扫显示左肾周围积液，平衡期CT增强扫描未见尿外渗。住院第4天，患者主诉背部疼痛加重，排泄期CT增强显示左肾盆腔破裂。我们放置了双j输尿管支架引流。术后确认尿外渗消失，无输尿管狭窄。结论钝性创伤患者肾周积液与出血CT表现不一致，可作为孤立性肾盆腔破裂的征象。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.