Isolated renal pelvis rupture secondary to blunt trauma: Case report

Isolated rupture of renal pelvis after blunt chest trauma: First description of a case

Isolated post-traumatic rupture of renal pelvis (IPTRRP) is an extremely rare condition and only a few cases following blunt abdominal trauma have been reported in the literature. To our knowledge, no cases of IPTRRP following blunt chest trauma have been reported. We present the case of an 84-year-old woman who was admitted to our Emergency Department due to persistent left flank pain that started after she had fallen to the ground 4 days before, with blunt trauma on her chest. CT showed a rupture of the left renal pelvis with contrast extravasation, associated with multiple rib fractures. No renal and other parenchymal injuries were detected. The patient was managed conservatively with the implantation of a ureteral stent and discharged in good clinical conditions. Our case shows the first description that IPTRRP might be an uncommon but possible complication of blunt chest trauma and must be included in the differential diagnosis.

Recurrent MALT lymphoma presenting as renal calyceal-pelvic rupture. What is the cause of this break?

Urinary collecting system rupture is an uncommon condition that usually occurs with symptoms of acute abdomen, secondary to peritoneal irritation by urine leaking. We report a case of a 49-year-old man admitted to our emergency department because of a worsening deep lower abdominal pain started 3 days before. The abdominal computed tomography revealed urine extravasation suggesting for urinoma. Because of patient pathological history of lymphoma, despite its apparent state of remission, he underwent a positron emission tomography - computed tomography with ¹⁸[F]-FDG and magnetic resonance in order to rule out a recurrence. Imaging supported the diagnostic hypothesis of a lymphatic recurrence that had compressed "ab-extrinseco" the urinary tract so much to break it. Based on our experience we can suggest that nontraumatic calyceal-pelvic rupture is an extremely rare manifestation of an onset of lymphoma.