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Mojtabaie P, Redmond CE, Lunt CR, Gibney B, Murray N, Louis L, Nicolaou S. Lower Urinary Tract Injuries: A Guide for the Emergency Radiologist. Can Assoc Radiol J 2020; 72:557-563. [PMID: 32391715 DOI: 10.1177/0846537120913875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Traumatic lower urinary tract injuries are uncommon and mainly occur in patients with severe trauma and multiple abdominopelvic injuries. In the presence of other substantial injuries, bladder and urethral injuries may be overlooked and cause significant morbidity and mortality. Therefore, it is important that radiologists are familiar with mechanisms and injuries that are high risk for bladder and urethral trauma. We review the imaging findings associated with these injuries and the appropriate modalities and techniques to further evaluate the patient and accurately diagnose these injuries. Computed tomography cystography and conventional retrograde urethrography are effective tools in identifying injuries to the lower urinary tract and play a crucial role in patient care and prognosis.
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Affiliation(s)
- Parmiss Mojtabaie
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Ciaran E Redmond
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Christopher R Lunt
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Brian Gibney
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Nicolas Murray
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Luck Louis
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Savvas Nicolaou
- Division of Emergency Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, British Columbia, Canada
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Coccolini F, Moore EE, Kluger Y, Biffl W, Leppaniemi A, Matsumura Y, Kim F, Peitzman AB, Fraga GP, Sartelli M, Ansaloni L, Augustin G, Kirkpatrick A, Abu-Zidan F, Wani I, Weber D, Pikoulis E, Larrea M, Arvieux C, Manchev V, Reva V, Coimbra R, Khokha V, Mefire AC, Ordonez C, Chiarugi M, Machado F, Sakakushev B, Matsumoto J, Maier R, di Carlo I, Catena F. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg 2019; 14:54. [PMID: 31827593 PMCID: PMC6886230 DOI: 10.1186/s13017-019-0274-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/23/2019] [Indexed: 12/22/2022] Open
Abstract
Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard. As with all traumatic conditions, the management of urogenital trauma should be multidisciplinary including urologists, interventional radiologists, and trauma surgeons, as well as emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines.
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Affiliation(s)
- Federico Coccolini
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia, 56124 Pisa, Italy
| | | | - Yoram Kluger
- Division of General Surgery Rambam Health Care Campus, Haifa, Israel
| | - Walter Biffl
- Trauma Surgery Dept., Scripps Memorial Hospital, La Jolla, California USA
| | - Ari Leppaniemi
- General Surgery Dept., Mehilati Hospital, Helsinki, Finland
| | - Yosuke Matsumura
- Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan
| | - Fernando Kim
- Urology Department, University of Colorado, Denver, USA
| | | | - Gustavo P. Fraga
- Trauma/Acute Care Surgery & Surgical Critical Care, University of Campinas, Campinas, Brazil
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Goran Augustin
- Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta Canada
| | - Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Imitiaz Wani
- Department of Surgery, DHS Hospitals, Srinagar, Kashmir India
| | - Dieter Weber
- Department of General Surgery, Royal Perth Hospital, Perth, Australia
| | - Emmanouil Pikoulis
- 3rd Department of Surgery, Attiko Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Martha Larrea
- General Surgery, “General Calixto García”, Habana Medicine University, Havana, Cuba
| | - Catherine Arvieux
- Clin. Univ. de Chirurgie Digestive et de l’Urgence, CHUGA-CHU Grenoble Alpes UGA-Université Grenoble Alpes, Grenoble, France
| | - Vassil Manchev
- General and Trauma Surgery Department, Pietermaritzburg Hospital, Pietermaritzburg, South Africa
| | - Viktor Reva
- General and Emergency Surgery, Sergei Kirov Military Academy, Saint Petersburg, Russia
| | - Raul Coimbra
- Department of General Surgery, Riverside University Health System Medical Center, Moreno Valley, CA USA
| | - Vladimir Khokha
- General Surgery Department, Mozir City Hospital, Mozir, Belarus
| | - Alain Chichom Mefire
- Department of Surgery and Obstetrics and Gynecology, University of Buea, Buea, Cameroon
| | - Carlos Ordonez
- Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia, 56124 Pisa, Italy
| | - Fernando Machado
- General and Emergency Surgery Department, Montevideo Hospital, Montevideo, Paraguay
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Junichi Matsumoto
- Department of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine, Kawasaki, Japan
| | - Ron Maier
- Department of Surgery, Harborview Medical Centre, Seattle, USA
| | - Isidoro di Carlo
- Department of Surgical Sciences and Advanced Technologies “GF Ingrassia”, Cannizzaro Hospital, University of Catania, Catania, Italy
| | - Fausto Catena
- Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy
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Heller MT, Oto A, Allen BC, Akin O, Alexander LF, Chong J, Froemming AT, Fulgham PF, Mackenzie DC, Maranchie JK, Mody RN, Patel BN, Schieda N, Turkbey IB, Venkatesan AM, Wang CL, Lockhart ME. ACR Appropriateness Criteria® Penetrating Trauma–Lower Abdomen and Pelvis. J Am Coll Radiol 2019; 16:S392-S398. [DOI: 10.1016/j.jacr.2019.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 11/25/2022]
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Cozzi D, Verrone GB, Agostini S, Bartolini M, D'Amico G, Pradella S, Miele V. Acute penile trauma: imaging features in the emergency setting. Radiol Med 2019; 124:1270-1280. [PMID: 31302847 DOI: 10.1007/s11547-019-01065-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/07/2019] [Indexed: 11/27/2022]
Abstract
In an emergency department, penile traumas are uncommon and a prompt diagnosis is necessary. Penile injury may result from penetrating and non-penetrating trauma. Non-penetrating injuries can produce cavernosal hematomas or fractures: if not treated promptly, these lesions can result in fibrosis or erectile dysfunction. Penile traumatic lesions need a clinical approach first, but a radiological study is often required: ultrasonography with color and spectral Doppler study is usually the first approach. In some cases, magnetic resonance imaging may be performed to better recognize even small discontinuity of the tunica albuginea. Radiologists have to be aware of the various radiological patterns of penile traumatic lesions, in order to establish a prompt and correct diagnosis.
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Affiliation(s)
- Diletta Cozzi
- Department of Radiology, Careggi University Hospital, Florence, Italy.
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy.
| | - Giovanni Battista Verrone
- Department of Radiology, Careggi University Hospital, Florence, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Simone Agostini
- Department of Radiology, Careggi University Hospital, Florence, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Marco Bartolini
- Department of Radiology, Careggi University Hospital, Florence, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Giuseppe D'Amico
- Department of Radiology, Careggi University Hospital, Florence, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Silvia Pradella
- Department of Radiology, Careggi University Hospital, Florence, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Florence, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
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Kawasaki S, Shigematsu H, Matsumori H, Maegawa N, Tanaka Y. Ureteral injury as a possible complication of vertebral fracture in a patient with ankylosing spinal hyperostosis. J Orthop Sci 2018; 23:194-196. [PMID: 27577522 DOI: 10.1016/j.jos.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 05/12/2016] [Accepted: 05/27/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Sachiko Kawasaki
- Department of Orthopedics and Surgery, Nara Medical University, Japan.
| | - Hideki Shigematsu
- Department of Orthopedics and Surgery, Nara Medical University, Japan
| | | | - Naoki Maegawa
- Department of Emergency and Critical Care Medicine, Nara Medical University, Japan
| | - Yasuhito Tanaka
- Department of Orthopedics and Surgery, Nara Medical University, Japan
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Abstract
BACKGROUND Injuries of the urinary bladder can be associated with blunt and penetrating abdominal or pelvic trauma. In addition, they can be an iatrogenic complication in open, laparoscopic, and endoscopic urogenital or abdominal surgery. OBJECTIVES The present article reviews relevant causes of bladder injuries and the subsequent diagnostic and treatment modalities.
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Abstract
PURPOSE OF REVIEW The geriatric population is the fastest growing segment of the population, and geriatric trauma patients are increasingly common. Caring for this population has unique challenges. The goal of the review is to identify factors that may help in the care of geriatric patients suffering from genitourinary trauma. RECENT FINDINGS Multiple factors lead to inferior outcomes in patients with geriatric trauma including failure to rescue, treatment in lower volume trauma centers, and undertriage of geriatric patients. Improvement in geriatric trauma outcomes occurs with the use of dedicated geriatric consult teams. The surgical management of genitourinary injuries in the geriatric population remains unchanged. SUMMARY Interventions for geriatric patients differ from younger populations. Direct changes in overall management of the geriatric population lead to improved outcomes. The treatment of geriatric trauma patients with genitourinary injuries is similar to a younger cohort. The lack of recent studies in clinical outcomes in this population has been identified as a gap in knowledge that will require future research to answer.
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Abstract
Nephrolithiasis, or stones, is one of the oldest urological diseases, with descriptions and treatment strategies dating back to ancient times. Despite the enormous number of patients affected by stones, a surprising lack of conceptual understanding of many aspects of this disease still exists. This lack of understanding includes mechanisms of stone formation and retention, the clinical relevance of different stone compositions and that of formation patterns and associated pathological features to the overall course of the condition. Fortunately, a number of new tools are available to assist in answering such questions. New renal endoscopes enable kidney visualization in much higher definition than was previously possible, while micro-CT imaging is the optimal technique for assessment of stone microstructure and mineral composition in a nondestructive fashion. Together, these tools have the potential to provide novel insights into the aetiology of stone formation that might unlock new prevention and treatment strategies, and enable more effective management of patients with nephrolithiasis.
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Urry RJ, Clarke DL, Bruce JL, Laing GL. The incidence, spectrum and outcomes of traumatic bladder injuries within the Pietermaritzburg Metropolitan Trauma Service. Injury 2016; 47:1057-63. [PMID: 26854075 DOI: 10.1016/j.injury.2016.01.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 01/02/2016] [Accepted: 01/15/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of this study is to provide a comprehensive overview of the incidence, spectrum and outcomes of traumatic bladder injury in Pietermaritzburg, South Africa, and to identify the current optimal investigation and management of patients with traumatic bladder injuries. METHODS The Pietermaritzburg Metropolitan Trauma Service (PMTS) trauma registry was interrogated retrospectively for all traumatic bladder injuries between 1 January 2012 and 31 October 2014. RESULTS Of 8129 patients treated by the PMTS over the study period, 58 patients (0.7% or 6.5 cases per 1,000,000 population per year) had bladder injuries, 65% caused by penetrating trauma and 35% by blunt trauma. The majority (60%) were intraperitoneal bladder ruptures (IBRs), followed by 22% extraperitoneal bladder ruptures (EBRs). There was a high rate of associated injury, with blunt trauma being associated with pelvic fracture and penetrating trauma being associated with rectum and small intestine injuries. The mortality rate was 5%. Most bladder injuries were diagnosed at surgery or by computed tomography (CT) scan. All IBRs were managed operatively, as well as 38% of EBRs; the remaining EBRs were managed by catheter drainage and observation. In the majority of operative repairs, the bladder was closed in two layers, and was drained with only a urethral catheter. Most patients (91%) were managed definitively by the surgeons on the trauma service. CONCLUSION Traumatic bladder rupture caused by blunt or penetrating trauma is rare and mortality is due to associated injuries. CT scan is the investigative modality of choice. In our environment IBR is more common than EBR and requires operative management. Most EBRs can be managed non-operatively, and then require routine follow-up cystography. Simple traumatic bladder injuries can be managed definitively by trauma surgeons. A dedicated urological surgeon should be consulted for complex injuries.
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Affiliation(s)
- R J Urry
- Department of Urology, Greys Hospital, Pietermaritzburg, South Africa; School of Clinical Medicine, University of KwaZulu-Natal, Nelson R Mandela School of Medicine, South Africa.
| | - D L Clarke
- Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg Metropolitan Hospitals Complex, Pietermaritzburg, South Africa; School of Clinical Medicine, University of KwaZulu-Natal, Nelson R Mandela School of Medicine, South Africa
| | - J L Bruce
- Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg Metropolitan Hospitals Complex, Pietermaritzburg, South Africa; School of Clinical Medicine, University of KwaZulu-Natal, Nelson R Mandela School of Medicine, South Africa
| | - G L Laing
- Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg Metropolitan Hospitals Complex, Pietermaritzburg, South Africa; School of Clinical Medicine, University of KwaZulu-Natal, Nelson R Mandela School of Medicine, South Africa
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Operative Interventionen urologischer Verletzungen beim schwerverletzten Patienten in der Akutphase. Urologe A 2016; 55:506-13. [DOI: 10.1007/s00120-015-0016-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kautza B, Zuckerbraun B, Peitzman AB. "Management of blunt renal injury: what is new?". Eur J Trauma Emerg Surg 2015; 41:251-8. [PMID: 26038034 DOI: 10.1007/s00068-015-0516-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/11/2015] [Indexed: 11/24/2022]
Abstract
The diagnosis, workup and management of blunt renal injury have evolved greatly over the past decades. Evaluation and management of blunt renal injury echoes the increasing success of nonoperative management in other blunt abdominal solid organ injury, such as liver and spleen. Decision-making difficulties still remain regarding the optimal imaging, grading and degree of interventional or operative exploration used. Increasingly, initial nonoperative management has gained acceptance and appears to be applicable even high-grade injuries. Emerging techniques in highly sensitive imaging as well as interventional angiography have allowed safe nonoperative management in the appropriate patient. This review will focus on the contemporary workup and management of blunt renal injury while focusing on some of the emerging literatures in regard to refined imaging and grading of injuries as well as techniques to increase the success of nonoperative management.
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Affiliation(s)
- B Kautza
- Department of Surgery, University of Pittsburgh, F1200 PUH 200 Lothrop St, Pittsburgh, PA, 15213, USA
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Berko NS, Dym RJ. Computed Tomographic Imaging of Renal and Ureteral Emergencies. Curr Probl Diagn Radiol 2015; 44:207-20. [DOI: 10.1067/j.cpradiol.2014.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/29/2014] [Accepted: 08/30/2014] [Indexed: 11/22/2022]
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Lumen N, Kuehhas FE, Djakovic N, Kitrey ND, Serafetinidis E, Sharma DM, Summerton DJ. Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol 2015; 67:925-9. [PMID: 25576009 DOI: 10.1016/j.eururo.2014.12.035] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 12/22/2014] [Indexed: 10/24/2022]
Abstract
CONTEXT The most recent European Association of Urology (EAU) guidelines on urologic trauma were published in 2014. OBJECTIVE To present a summary of the 2014 version of the EAU guidelines on urologic trauma of the lower urinary tract with an emphasis on diagnosis and treatment. EVIDENCE ACQUISITION The EAU Trauma Panel reviewed the English-language literature via a Medline search for lower urinary tract injury (LUTI) up to November 2013. The focus was on newer publications and reviews, although older key references could be included. EVIDENCE SYNTHESIS A full version of the guidelines is available in print (EAU Guidelines 2014 edition, ISBN/EAN 978-90-79754-65-6) and online (www.uroweb.org). Blunt trauma is the main cause of LUTI. The preferred diagnostic modality for bladder and urethral injury is cystography and urethrography, respectively. In the treatment of bladder injuries, it is important to distinguish between extra- and intraperitoneal ruptures. Treatment of male anterior urethral injuries depends on the cause (blunt vs penetrating vs penile-fracture-related injury). Blunt posterior urethral injuries can be corrected by immediate/early endoscopic realignment. If this is not possible, such injuries are managed by suprapubic urinary diversion and deferred (>3 mo) urethroplasty. Treatment of female urethral injuries depends on the location of the injury and is usually surgical. CONCLUSIONS Correct treatment of LUTIs is important to minimise long-term urinary symptoms and sexual dysfunction. This review performed by the EAU trauma panel summarises the current management of LUTIs. PATIENT SUMMARY Patients with trauma to the lower urinary tract benefit from accurate diagnosis and appropriate treatment according to the nature and severity of their injury.
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Affiliation(s)
- Nicolaas Lumen
- Department of Urology, Ghent University Hospital, Ghent, Belgium.
| | | | - Nenad Djakovic
- Department of Urology, Mühldorf General Hospital, Mühldorf am Inn, Germany
| | - Noam D Kitrey
- Department of Urology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | | | | | - Duncan J Summerton
- Department of Urology, University Hospitals of Leicester NHS Trust, Leicester, UK
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von Klot CAJ, Zeckey C, Tezval H. Can we predict the clinical outcome of patients with bladder trauma? World J Urol 2013; 31:1017-8. [DOI: 10.1007/s00345-013-1028-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 01/18/2013] [Indexed: 11/29/2022] Open
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Current world literature. Curr Opin Urol 2012; 22:521-8. [PMID: 23034511 DOI: 10.1097/mou.0b013e3283599868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Oh IS, Chang DG, Kim YH, Ha KY. Pure hyperextension injury of the lower lumbar spine with an ureteral impingement. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 22 Suppl 3:S353-6. [PMID: 22836367 DOI: 10.1007/s00586-012-2450-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 06/05/2012] [Accepted: 07/14/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Pure hyperextension thoracolumbar spinal fractures are unusual and occur primarily in patients with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis due to the rigidity of the spine. MATERIAL AND METHODS A 62-year-old female with osteoporosis presented with a significantly displaced fourth vertebral body fracture after being hit by a motorcycle. An imaging study showed widening of the vertebral height of L4 anteriorly with a horizontal fracture extending across the vertebral body. An in situ instrumented lumbar fusion from the second to fifth lumbar vertebrae was performed. Postoperatively, the patient complained of abdominal pain and difficulty in voiding. Computed tomography and intravenous pyelography showed that the right ureter was impinged between the fractured gaps of the vertebral body of L4. RESULTS Solid bony union was obtained with surgical intervention. CONCLUSIONS This case reports a rare distractive extension injury in the lower lumbar spine with ureteral impingement. One should be aware of possible complications such as ureteral impingement following a pure hyperextension injury in the lower lumbar spine.
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Affiliation(s)
- In-Soo Oh
- Department of Orthopaedic Surgery, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Latini J. How Has Genitourinary Trauma Management Changed? J Urol 2012; 188:14-5. [DOI: 10.1016/j.juro.2012.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jerilyn Latini
- Department of Urology, University of Michigan, Ann Arbor, Michigan
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Wolters HH, Vowinkel T. Risks in life after living kidney donation. Nephrol Dial Transplant 2012; 27:3021-3. [PMID: 22619313 DOI: 10.1093/ndt/gfs150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Heiner H Wolters
- Department of General and Visceral Surgery, University Hospital Muenster, Muenster, Germany.
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Pereira BMT, de Campos CCC, Calderan TRA, Reis LO, Fraga GP. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World J Urol 2012; 31:913-7. [PMID: 22544337 DOI: 10.1007/s00345-012-0871-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 04/12/2012] [Indexed: 02/06/2023] Open
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