EURORAD ESR

Case 10142

Intraoperative ureteral injury with iatrogenic urinoma: multidetector CT-urography findings and role

Author(s)
Tonolini Massimo, M.D.

"Luigi Sacco" University Hospital, Radiology Department;
Via G.B. Grassi 74 20157 Milan, Italy;
Email: mtonolini@sirm.org
 
Patient
male, 66 year(s)
 
 
  • Figure 1
    Preoperative contrast-enhanced CT

    Prior to elective recanalization surgery, normal appearance of left-sided colostomy is observed, with exclusion of residual abscess collections in both abdomen and anterior abdominal wall.

     
    Area of Interest: Colon; Imaging Technique: CT; Procedure: Complications; Special Focus: Infection;
     
     
  • Figure 2
    Double-contrast barium enema
     

    Prior to elective recanalization surgery, double-contrast enema through left-sided colostomy (a) does not reveal significant abnormalities of the upstream descending and transverse colon, whereas the rectal stump is...

     
    Area of Interest: Colon; Imaging Technique: Fluoroscopy; Procedure: Barium enema; Special Focus: Acute;

    Prior to elective recanalization surgery, double-contrast enema through left-sided colostomy (a) does not reveal significant abnormalities of the upstream descending and transverse colon, whereas the rectal stump is...

     
    Area of Interest: Colon; Imaging Technique: Fluoroscopy; Procedure: Barium enema; Special Focus: Acute;
     
     
  • Figure 3
    Early postoperative multidetector CT-urography
     

    On unenhanced scans the peritoneal cul-de-sac is occupied by a moderate-sized fluid-attenuation collection (*). Air in the bladder lumen. Left-sided ureteral stent and surgical drainage are present.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Complications; Special Focus: Acute;

    Excretory phase acquisition after intravenous contrast medium show opacified right ureter (arrow).

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Complications; Special Focus: Acute;

    Excretory phase acquisition after intravenous contrast medium show opacified right ureter (arrow), with extraluminal opaque urine leak filling the pelvic collection (arrowheads) consistent with urinoma.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Complications; Special Focus: Acute;

    Three-dimensional volume rendering images from multidetector CT-urography depict thin, discontinuous right pelvic ureter with extraluminal opacification consistent with urinoma (arrowheads). Left ureteral stent in place.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Complications; Special Focus: Acute;

    Three-dimensional volume rendering images from multidetector CT-urography depict thin, discontinuous right pelvic ureter with extraluminal opacification consistent with urinoma (arrowheads). Left ureteral stent in place.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Complications; Special Focus: Acute;
     
     
Prior to elective recanalization surgery, normal appearance of left-sided colostomy is observed, with exclusion of residual abscess collections in both abdomen and anterior abdominal wall.
 
Prior to elective recanalization surgery, double-contrast enema through left-sided colostomy (a) does not reveal significant abnormalities of the upstream descending and transverse colon, whereas the rectal stump is collapsed (b).
 
Prior to elective recanalization surgery, double-contrast enema through left-sided colostomy (a) does not reveal significant abnormalities of the upstream descending and transverse colon, whereas the rectal stump is collapsed (b).
 
On unenhanced scans the peritoneal cul-de-sac is occupied by a moderate-sized fluid-attenuation collection (*). Air in the bladder lumen. Left-sided ureteral stent and surgical drainage are present.
 
Excretory phase acquisition after intravenous contrast medium show opacified right ureter (arrow).
 
Excretory phase acquisition after intravenous contrast medium show opacified right ureter (arrow), with extraluminal opaque urine leak filling the pelvic collection (arrowheads) consistent with urinoma.
 
Three-dimensional volume rendering images from multidetector CT-urography depict thin, discontinuous right pelvic ureter with extraluminal opacification consistent with urinoma (arrowheads). Left ureteral stent in place.
 
Three-dimensional volume rendering images from multidetector CT-urography depict thin, discontinuous right pelvic ureter with extraluminal opacification consistent with urinoma (arrowheads). Left ureteral stent in place.
 
 
 
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