View source for Ureter trauma

==Background==
[[File:Urinary system.png|thumb|'''(1) Human urinary system:''' (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra. <Br>'''Additional structures:''' (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.]]
[[File:Blausen 0592 KidneyAnatomy 01.png|thumb|Renal anatomy.]]
[[File:PMC5265200 13244 2016 536 Fig1 HTML.png|thumb|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]
*90% of non-iatrogenic injuries occur from penetrating injury
*Isolated ureter injury is rare

==Clinical Features<ref>https://www.merckmanuals.com/professional/injuries-poisoning/genitourinary-tract-trauma/ureteral-trauma</ref>==
*Symptoms usually nonspecific
*[[Hematuria]] present in ~70%
*Delayed signs of occult injury include:
**[[Fever]]/[[sepsis]], [[flank pain]], [[ileus]], urinary leakage or obstruction
*Complications include :
**Peritoneal or retroperitoneal urinary leakage
**[[Perinephric abscess]]
**Fistula formation (e.g. ureterovaginal, uterocutaneous)
**Ureteral stricture/obstruction

==Differential Diagnosis==
{{Lower GU trauma DDX}}
{{Abdominal trauma DDX}}

==Evaluation==
*Absence of hematuria does NOT rule out ureteral injury
*If CT is nondiagnostic but high index of suspicion perform IV urography or retrograde pyelography

==Management==
*Surgery

==Disposition==
*Admit

==See Also==
*[[Genitourinary trauma]]

==References==
[[Category:Renal]]
[[Category:Trauma]]
[[Category:Urology]]