Nontraumatic Rupture of Urinary Tract

Nontraumatic extravasation of contrast medium is an uncommon finding during intravenous urography (IVU). Retrospective review of seven patients with spontaneous rupture of urinary tract during the years 1987-1993 showed an age range of 28 to 67 years (mean, 54 years), and included five males and two females. Clinical presentations of the patients were unilateral flank pain (six patients) and diffuse abdominal pain (one patient). All the patients received intravenous urography (IVU) study because of the flank or abdominal pain. Only three of the patients had computed tomography (CT) of abdomen. Six out of seven patients (86%) suffered from ureteral obstruction secondary to urolithiasis. The other, who did not have urolithiasis, had previously an appendectomy. Extravasation of contrast medium during IVU was found from the upper urinary tract in all cases. The most important aim of therapy is relief of ureteral obstruction. Only two required surgical exploration. The least invasive management, with double J stent, was performed in the others with good.