Emergency Cases Northwest Group

039 Internal Leak

Situation

Kidney stone caused urine leak in retroperitoneum.

Background

A 65 year old man with no urological history had severe left sided abdominal pain. Some tenderness on examination but observations normal, labs: wcc normal, crp <4. But lactate was 7 so CT done ?ischaemic bowel.

Imagining showed obstructing ureteric stone with urine extravasated: likely ureteric perforation.

Assessment

The stone had caused obstruction and a urine leak into the surrounding area.

Recommendation

Know that urine leaks like this can happen from urological obstruction including from stones [or from trauma].

Sometimes they can form urininomas.

Management is with Abx and observation although draining a urinoma is also possible if large.

Note WCC normal and crp <4 even though the patient had a serious cause of his abdominal pain.

PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group