SPONTANEOUS perforation of the kidney or renal pelvis following excretory urography or impaction of a calculus in the ureter is rare, but well documented.1-5 Perforation at the site of impaction, however, must be very rare indeed; only one previous case could be found in the literature.6 This is a report of another such case, in which perforation resulted in the loss of the involved kidney.
Report of a Case
A previously healthy 32-year-old white man presented with typical colic of the right ureter. X-ray examination revealed a dumbbell-shaped calculus in the right ureter just below the level of the fourth lumbar transverse process (Fig 1). Over the next few days the stone moved downwards to become arrested at the level of the first sacral vertebra. The presence of incipient hydronephrosis on excretory urogram and continued pain prompted cystoscopy, during which a Dormia basket was introduced into the right
Munster AM, Hunter JJ. Urinary Extravasation Due to Perforation of the Ureter by a Calculus: Report of a Case. Arch Surg. 1968;97(4):632–633. doi:10.1001/archsurg.1968.01340040128024
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