Acute Abdominal Pain Due to Spontaneous Renal Calyceal Rupture: Clinical Presentation, Diagnosis and Management

Abstract

Background: Rupture of renal calyces with urinoma, mimicking acute abdomen, is an unusual condition that is mostly caused by distal ureteral stone. Case Presentation: Ultrasonographic evaluation showed right hydronephrosis in a woman who was admitted to our emergency department with persistent severe abdominal pain. A delayed contrast -enhanced computerized tomography (CT) was required to confirm the diagnosis of rupture in symptomatically worsening patient. Among various treatment options conservative treatment was preferred, the patient was recovered, and urinoma was resolved without any complication. Diagnosis and treatment options are discussed. Conclusion: A spontaneous rupture of the urinary system can mimic acute abdomen, and should always be considered in the differential diagnosis of a patient presenting complex symptoms after renal colic. If a definite diagnosis cannot be established by routine imaging modalities, delayed phase contrast- enhanced CT would be helpful in this regard. Conservative treatment with careful monitoring is an option with good results, thus it may obviate the need for surgical intervention in most of the patients.