Case Report
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Clin Cases. Apr 16, 2014; 2(4): 108-110
Published online Apr 16, 2014. doi: 10.12998/wjcc.v2.i4.108
Spontaneous rupture of the renal pelvis presenting as an urinoma in locally advanced rectal cancer
Pankaj Kumar Garg, Debajyoti Mohanty, Vinita Rathi, Bhupendra Kumar Jain
Pankaj Kumar Garg, Debajyoti Mohanty, Bhupendra Kumar Jain, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
Pankaj Kumar Garg, Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
Vinita Rathi, Department of Radiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
Author contributions: Garg PK and Mohanty D designed the report; all the authors actively managed the patient; Garg PK and Mohanty D collected the patient’s clinical data; all the authors analyzed the case, drafted the manuscript and finally approved it.
Correspondence to: Dr. Pankaj Kumar Garg, Assistant Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India. dr.pankajgarg@gmail.com
Telephone: +91-11-22692536 Fax: +91-11-22590495
Received: December 25, 2013
Revised: January 26, 2014
Accepted: February 20, 2014
Published online: April 16, 2014
Processing time: 106 Days and 4.8 Hours
Abstract

A 29-year-old gentleman underwent a transverse colostomy for intestinal obstruction caused by advanced rectal carcinoma. On the 5th postoperative day, the patient developed a painful swelling on the right side of the abdomen. The contrast enhanced computed tomography of the abdomen revealed a right sided hydronephrosis, a large rent in the renal pelvis, and a large retroperitoneal fluid collection on the right side. Percutaneous nephrostomy and pigtail catheter drainage of the urinoma led to resolution of abdominal swelling. Development of a urinoma as a consequence of rectal carcinoma is highly unusual. Prompt imaging for confirmation of diagnosis, decompression of the renal pelvicalyceal system, and drainage of the urinoma limits morbidity.

Keywords: Colorectal cancer; Urinoma; Spontaneous rupture of the renal pelvis; Percutaneous nephrostomy; Pigtail catheter drainage

Core tip: A recent development of a loin swelling in a patient with a malignant pelvic tumor should alert the clinician to the possibility of a urinoma due to spontaneous rupture of the obstructed renal pelvis. Early imaging for confirmation of diagnosis and decompression of the renal pelvicalyceal system help to arrest a further downhill course of the patients.