Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report

Back ground: Renal pelvis rupture due to trauma is commonly diagnosed in an excretory phase CT scan, which is not be applied in substantial proportion of trauma patients during initial evaluation. Since renal pelvis rupture has no specific findings, there is no clear indication to perform an excreto...

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Main Authors: Yukiko Asanuma, Motoo Fujita, Tomomi Sato, Takuma Sato, Shigeki Kushimoto
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Trauma Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352644025000974
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author Yukiko Asanuma
Motoo Fujita
Tomomi Sato
Takuma Sato
Shigeki Kushimoto
author_facet Yukiko Asanuma
Motoo Fujita
Tomomi Sato
Takuma Sato
Shigeki Kushimoto
author_sort Yukiko Asanuma
collection DOAJ
description Back ground: Renal pelvis rupture due to trauma is commonly diagnosed in an excretory phase CT scan, which is not be applied in substantial proportion of trauma patients during initial evaluation. Since renal pelvis rupture has no specific findings, there is no clear indication to perform an excretory phase CT scan in the evaluation of trauma patients. We experienced a case presented with low-density fluid accumulation around kidney on plain CT imaging, subsequently diagnoses as having isolated renal pelvis injury. Case presentation: 68-year-old male fell from the second floor and referred to our institution. He had pain in his left buttock with a subcutaneous hematoma. He presented as blood pressure of 155 mmHg, heart rate of 145 beats/min, and blood test showed no specific abnormalities. Plain CT showed fluid accumulation around the left kidney, and following a contrast-enhanced CT scan at equilibrium phase showed no urinary extravasation. On the 4th hospital day, he complained of worsening back pain, and excretion phase of contrast-enhanced CT revealed left renal pelvic rupture. We placed a double-J ureteral stent for urinary drainage. Thereafter, disappearance of urinary extravasation without ureteral stricture was confirmed. Conclusion: In patients with blunt trauma, perirenal effusion collection inconsistent with hemorrhage on CT imaging could be considered as a sign of isolated renal pelvic rupture.
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spelling doaj-art-b7ced40bfc214a09af4cdcdf27dc9cdc2025-08-20T03:36:19ZengElsevierTrauma Case Reports2352-64402025-08-015810122010.1016/j.tcr.2025.101220Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case reportYukiko Asanuma0Motoo Fujita1Tomomi Sato2Takuma Sato3Shigeki Kushimoto4Department of Emergency Critical Care Medicine, Tohoku University Hospital, Japan; Corresponding author at: 1-1, Seiryo-mashi, Aoba-ku, Sendai-shi, Miyagi 980-8574, Japan.Department of Emergency Critical Care Medicine, Tohoku University Hospital, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, JapanDepartment of Urology, Tohoku University Hospital, JapanDepartment of Emergency Critical Care Medicine, Tohoku University Hospital, JapanBack ground: Renal pelvis rupture due to trauma is commonly diagnosed in an excretory phase CT scan, which is not be applied in substantial proportion of trauma patients during initial evaluation. Since renal pelvis rupture has no specific findings, there is no clear indication to perform an excretory phase CT scan in the evaluation of trauma patients. We experienced a case presented with low-density fluid accumulation around kidney on plain CT imaging, subsequently diagnoses as having isolated renal pelvis injury. Case presentation: 68-year-old male fell from the second floor and referred to our institution. He had pain in his left buttock with a subcutaneous hematoma. He presented as blood pressure of 155 mmHg, heart rate of 145 beats/min, and blood test showed no specific abnormalities. Plain CT showed fluid accumulation around the left kidney, and following a contrast-enhanced CT scan at equilibrium phase showed no urinary extravasation. On the 4th hospital day, he complained of worsening back pain, and excretion phase of contrast-enhanced CT revealed left renal pelvic rupture. We placed a double-J ureteral stent for urinary drainage. Thereafter, disappearance of urinary extravasation without ureteral stricture was confirmed. Conclusion: In patients with blunt trauma, perirenal effusion collection inconsistent with hemorrhage on CT imaging could be considered as a sign of isolated renal pelvic rupture.http://www.sciencedirect.com/science/article/pii/S2352644025000974Renal pelvic ruptureBlunt traumaFluid accumulation on CT imaging
spellingShingle Yukiko Asanuma
Motoo Fujita
Tomomi Sato
Takuma Sato
Shigeki Kushimoto
Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report
Trauma Case Reports
Renal pelvic rupture
Blunt trauma
Fluid accumulation on CT imaging
title Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report
title_full Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report
title_fullStr Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report
title_full_unstemmed Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report
title_short Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report
title_sort isolated renal pelvis rupture due to blunt trauma presenting with low density fluid accumulation around kidney on initial ct a case report
topic Renal pelvic rupture
Blunt trauma
Fluid accumulation on CT imaging
url http://www.sciencedirect.com/science/article/pii/S2352644025000974
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