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Spontaneous renal forniceal rupture due to advanced cervical carcinoma with obstructive uropathy

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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aims

To report and describe the clinical presentation and outcome of a woman presenting with gross perinephric urinary extravasation (due to spontaneous renal forniceal rupture), secondary to malignant obstructive uropathy caused by advanced cervical carcinoma. To review the etiopathogenesis, approach to diagnosis and management of ‘spontaneous renal forniceal rupture.

Methods

The published English literature (PubMed™) was searched for similar cases of ‘spontaneous renal forniceal rupture’ using the keywords: carcinoma cervix, metastatic carcinoma cervix, renal pelvis rupture, renal fornix rupture, spontaneous renal fornix rupture and urinoma.

Results

The diagnosis of renal forniceal rupture with gross urinoma formation secondary to advanced cervical carcinoma was suspected on ultrasound and was subsequently confirmed by a computed tomographic scan of the abdomen. Percutaneous nephrostomy with a pigtail catheter resolved the urinoma. Search results for similar cases yielded several causes of spontaneous renal forniceal rupture, however, only one such case report due to advanced cervical carcinoma was found.

Conclusion

To the best of our knowledge, this is the second case of spontaneous renal forniceal rupture secondary to ureteral obstruction caused by advanced cervical carcinoma to be reported in the published English literature. A high clinical index of suspicion is warranted in any patient of advanced cervical carcinoma that presents with sudden uremia or oliguria with flank pain and swelling in order to arrive at an early diagnosis. A decompressive nephrostomy may provide the much needed comfort and succor towards prolonging the life of such unfortunate patients.

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References

  1. Koktener A, Unal D, Dilmen G, Koc A (2007) Spontaneous rupture of the renal pelvis caused by calculus: a case report. J Emerg Med 33(2):127–129. doi:10.1016/j.jemermed.2006.12.031

    Article  PubMed  Google Scholar 

  2. Georgieva M, Thieme M, Pernice W, Tröbs RB (2003) Urinary ascites and perirenal urinoma—a renoprotective “Complication” of posterior urethral valves. Aktuelle Urol 34(6):410–412. doi:10.1055/s-2003-43175

    Article  PubMed  CAS  Google Scholar 

  3. Taari K, Lindell O, Mankinen P, Markkola A (1994) Shoulder pain due to rupture of a calyceal diverticulum as an acute sign of prostatic hyperplasia. Br J Urol 73(4):458–459

    Article  PubMed  CAS  Google Scholar 

  4. Van Winter JT, Ogburn PL Jr, Engen DE, Webb MJ (1991) Spontaneous renal rupture during pregnancy. Mayo Clin Proc 66(2):179–182

    PubMed  Google Scholar 

  5. Cormio G, Cormio L, Di Gesu’ G, Loverro G, Selvaggi L (2001) Calyceal rupture and perirenal urinoma as a presenting sign of recurrent ovarian cancer. Gynecol Oncol 83(2):415–417. doi:10.1006/gyno.2001.6360

    Article  PubMed  CAS  Google Scholar 

  6. Spurlock JW, Burke TW, Dunn NP, Heller PB, Collins HS, Park RC (1987) Calyceal rupture with perirenal urinoma in a patient with cervical carcinoma. Obstet Gynecol 7:511–513

    Google Scholar 

  7. Fukatsu T, Tajima K, Saitou K (2001) Rupture of renal pelvis due to urolithiasis: report of two cases. Hinyokika Kiyo 47(1):39–42

    PubMed  CAS  Google Scholar 

  8. Ferri E, Casoni GL, Morabito G, D’Alonzo L, Magrini L, Di Somma S, Capotondi C (2006) Rupture of the renal pelvis complicating a renal colic: report of a case. Am J Emerg Med 24(3):383–385. doi:10.1016/j.ajem.2005.11.011

    Article  PubMed  Google Scholar 

  9. Huang E, Sayegh R, Craigo S, Chelmow D (2002) Rupture of the renal pelvis associated with intravenous fluid bolus. J Matern Fetal Neonatal Med 11(5):345–346. doi:10.1080/713605546

    Article  PubMed  CAS  Google Scholar 

  10. Kalafatis P, Zougkas K, Petas A (2004) Primary ureteroscopic treatment for obstructive ureteral stone-causing fornix rupture. Int J Urol 11(12):1058–1064. doi:10.1111/j.1442-2042.2004.00949.x

    Article  PubMed  Google Scholar 

  11. Breun H, Csapo Z, Sigel A (1989) Fornix rupture—a review of pathophysiology and clinical aspects. Urologe A 28(6):329–333

    PubMed  CAS  Google Scholar 

  12. Koga S, Arakaki Y, Matsuoka M, Ohyama C (1992) Spontaneous peripelvic extravasation of urine. Int Urol Nephrol 24(5):465–469. doi:10.1007/BF02550112

    Article  PubMed  CAS  Google Scholar 

  13. Koktener A, Unal D, Dilmen G, Koc A (2007) Spontaneous rupture of the renal pelvis caused by calculus: a case report. J Emerg Med 33(2):127–129. doi:10.1016/j.jemermed.2006.12.031

    Article  PubMed  Google Scholar 

  14. Eggerath A, Friedrichs R (1985) Evaluation of spontaneous renal extravasation of contrast media in the excretory urogram. Radiologe 25(5):224–229

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, UCMS and GTBH, F-14 South Extension Part-2, New Delhi, 110049, India

    Iqbal Singh

  2. Department of Surgery, UCMS and GTBH, University of Delhi, Delhi, 110095, India

    Mohit Joshi

  3. Department of Radiology, UCMS and GTBH, University of Delhi, Delhi, 110095, India

    Gopesh Mehrotra

Authors
  1. Iqbal Singh
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  2. Mohit Joshi
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  3. Gopesh Mehrotra
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Correspondence to Iqbal Singh.

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Singh, I., Joshi, M. & Mehrotra, G. Spontaneous renal forniceal rupture due to advanced cervical carcinoma with obstructive uropathy. Arch Gynecol Obstet 279, 915–918 (2009). https://doi.org/10.1007/s00404-008-0817-y

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  • DOI: https://doi.org/10.1007/s00404-008-0817-y

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