Ureter trauma

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:
  • 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