Spontaneous or non-traumatic
rupture of the renal tract is an infrequent presentation, and it is most frequently caused by ureteric obstruction.
Rupture could occur at any level of the upper urinary tract. However, it is most common at the renal calyces and complications that could arise include;
urinoma, and or
hematoma collection which could progress to
abscess formation and
sepsis. We report a 77-year-old male patient who attended the emergency department following referral from his general practitioner with a 6-day history of progressively worsening left sided
abdominal pain. Due to his co-morbidities, presenting blood pressure and age, he was suspected of having an
aortic dissection or ruptured
abdominal aortic aneurysm and subsequently had a CT (computed tomography) Angiogram. This showed extravasation of contrast from the left kidney with a 12 mm obstructing vesico-ureteric junction
calculus necessitating urgent urology referral and prompt review. He was worked up for a ureteric double J
stent insertion, however, the procedure was unsuccessful due to complex multiple
urethral strictures. The patient subsequently had a
nephrostomy inserted and was planned for optical urethrotomy, rigid cystoscopy, rigid/flexible ureteroscopy, and
laser stone fragmentation of left obstructing vesico-ureteric junction
calculus.