Ureter trauma

(Redirected from Ureter Trauma)

Background

(1) Human urinary system: (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra.
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.
Renal anatomy.
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[1]

  • Symptoms usually nonspecific
  • Hematuria present in ~70%
  • Delayed signs of occult injury include:
  • Complications include :
    • Peritoneal or retroperitoneal urinary leakage
    • Perinephric abscess
    • Fistula formation (e.g. ureterovaginal, uterocutaneous)
    • Ureteral stricture/obstruction

Differential Diagnosis

Abdominal 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

See Also

References