The Teaching Point

There is an increased risk of renal pelvis rupture in trauma patients with pre-existing hydronephrosis or other renal abnormalities. CECT is the preferred imaging modality for evaluating renal injury in the setting of trauma, and requires both portal venous and delayed phase imaging. Delayed phase imaging will not only confirm the presence of urine extravasation, but may also help locate the site of urine leak.






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From the manuscript

Delayed Rupture of the Renal Collecting System Secondary to a Traumatic Hemorrhage in the Setting of Suspected Chronic Ureteropelvic Junction Obstruction

Free full text article: Delayed Rupture of the Renal Collecting System Secondary to a Traumatic Hemorrhage in the Setting of Suspected Chronic Ureteropelvic Junction Obstruction

Abstract
Isolated rupture of the renal pelvis secondary to blunt trauma is rare, though there is increased incidence in the setting of a pre-existing renal abnormality that predisposes the kidney to injury. We report a case of post-traumatic hemorrhage into the renal collecting system leading to delayed rupture of the renal pelvis in the setting of suspected chronic ureteropelvic junction obstruction. This case illustrates the difficulty in diagnosis of acute hemorrhage into the renal collecting system. Special attention should be given to a kidney with a pre-existing abnormality in the setting of trauma to prevent complications. A literature review of hemorrhage into the collecting system along with appropriate imaging and management are discussed.






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1. Rupture

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3. Ureteropelvic Junction

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5. Hydronephrosis

6. Kidney

7. Computed Tomography


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