Ureter trauma: Difference between revisions
m (Rossdonaldson1 moved page Ureter Trauma to Ureter trauma) |
ClaireLewis (talk | contribs) |
||
| (5 intermediate revisions by 4 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*90% of injuries occur from penetrating injury | *90% of non-iatrogenic injuries occur from penetrating injury | ||
*Isolated ureter injury is rare | *Isolated ureter injury is rare | ||
==Clinical Features== | ==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== | ==Differential Diagnosis== | ||
{{Abdominal trauma DDX}} | {{Abdominal trauma DDX}} | ||
== | ==Evaluation== | ||
*Absence of hematuria does NOT rule out ureteral injury | *Absence of hematuria does NOT rule out ureteral injury | ||
*If CT is nondiagnostic but high index of suspicion perform IV urography or retrograde pyelography | *If CT is nondiagnostic but high index of suspicion perform IV urography or retrograde pyelography | ||
| Line 19: | Line 28: | ||
==See Also== | ==See Also== | ||
[[ | *[[Genitourinary trauma]] | ||
==References== | ==References== | ||
[[Category: | [[Category:Renal]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category:Urology]] | |||
Revision as of 23:13, 17 October 2019
Background
- 90% of non-iatrogenic injuries occur from penetrating injury
- Isolated ureter injury is rare
Clinical Features[1]
- 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
Abdominal Trauma
- Abdominal compartment syndrome
- Diaphragmatic trauma
- Duodenal hematoma
- Genitourinary trauma
- Liver trauma
- Pelvic fractures
- Retroperitoneal hemorrhage
- Renal trauma
- Splenic trauma
- Trauma in pregnancy
- Ureter trauma
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