An 87-year-old woman was referred to us with lower-right abdominal pain, a fever, and vomiting. Computed tomography of her abdomen revealed several renal cysts and right hydronephrosis with peripelvic urinary extravasation (PUE) (Picture; white arrows). Furthermore, a right internal iliac aneurysm (IIA) was observed (Picture C; black arrows). No causal factors of PUE, including trauma, were found. We believed that right ureteral exclusion due to a right IIA had caused the spontaneous PUE. Computed tomography performed two weeks later showed that PUE had improved; however, the right IIA did not change. She was discharged without any serious symptoms after one month. Spontaneous PUE is most often observed in acute obstruction due to ureteral calculus; however, it may develop from other causes (1, 2). For example, since the ureter was movable, the ureteral obstruction may have been released due to the posture of the patient. As shown here, IIA should be considered in the differential diagnosis of PUE.
Picture.
The authors state that they have no Conflict of Interest (COI).
References
- 1. Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR. Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics 23: 1133-1147, 2003. [DOI] [PubMed] [Google Scholar]
- 2. Chien JC, Chang PY, Chan WP. Bilateral spontaneous peripelvic urinary extravasation. Kidney Int 86: 448, 2014. [DOI] [PubMed] [Google Scholar]