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Intraoperative Ultrasound in Spinal Surgery
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Ureteric avulsion caused by lumbar exostosis.
A Miernik1, C Halscheid, A Frankenschmidt
1Department of Urology and Pediatric Urology, University of Freiburg, Freiburg, Germany. arkadiusz.miernik @ uniklinik-freiburg.de
Urologia Internationalis
|August 9, 2011
Summary
A 72-year-old woman experienced ureteral avulsion due to circulatory collapse. Prompt diagnosis and open surgery were crucial for restoring kidney function, highlighting the need for awareness of this rare injury.
Area of Science:
- Urology
- Trauma Surgery
- Emergency Medicine
Background:
- Ureteral avulsion, particularly at the ureteropelvic junction (UPJ), is a rare but serious injury.
- Circulatory collapse can lead to spontaneous or trauma-induced ureteral injuries.
- Early diagnosis is challenging in emergency settings due to non-specific symptoms.
Observation:
- A 72-year-old female presented with ureteral avulsion following home circulatory collapse.
- Imaging revealed left hydronephrosis and perirenal fluid.
- Retrograde pyelography confirmed ureteral disruption at the UPJ.
Findings:
- The patient underwent immediate open surgery to repair the ureteropelvic junction.
- Diagnosis of UPJ transection is often delayed in emergency departments.
- Degenerative changes may increase the incidence of such injuries in the elderly.
Implications:
- Trauma specialists must consider UPJ transection in patients with unexplained hydronephrosis after circulatory collapse.
- Increased awareness of this pathology is vital for timely and effective management.
- The aging population may lead to a higher frequency of this specific injury pattern.
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