IMAGES IN EMERGENCY MEDICINE
Spontaneous rupture of kidney
1 Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan
2 Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
3 Department of Surgery, Division of Urology, Cardinal Tien Hospital, Taipei, Taiwan
4 College of Medicine, Fu-Jen University, Taipei, Taiwan
Correspondence to:
Correspondence to Dr C-H Liao, 362 Chung Cheng Road, Hsintien Taipei County 231, Taiwan; liaoch22@so-net.net.tw
Accepted 10 July 2008
| The first 150 words of the full text of this article appear below. |
A 27-year-old woman had a history of right renal stone and had received extracorporeal shock wave lithotripsy 2 years before visiting the emergency department. She presented with severe right renal colic with nausea and vomiting. On physical examination, tenderness over the right upper abdomen and right flank was observed. Laboratory tests showed leucocytosis (white blood cell count 12 750/µl); urinalysis did not reveal pyuria or haematuria. Abdomen ultrasonography showed a right renal stone and minimal hydronephrosis. She received antimicrobial therapy for acute pyelonephritis. However, her renal colic and vomiting persisted.
Intravenous urography showed contrast medium extravasation (fig 1). Computed tomography scan of the abdomen confirmed the diagnosis of a small right ureteropelvic stone, with leakage of contrast medium into the perirenal and anterior pararenal space (fig 2). Emergency ureteroscopy with ureteral stenting resolved her symptoms. Even a small ureteral stone can cause spontaneous kidney rupture, and
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