Related Experiment Videos
Ureteral obstruction secondary to sigmoid diverticulitis
Y Kubota1, S Kawamura, N Ishii
1Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.
Urologia Internationalis
|January 1, 1988
Summary
Diverticulitis can cause ureteral obstruction due to inflammation and fibrosis. This case highlights a rare cause of hydronephrosis requiring surgical intervention for ureterolysis and sigmoidectomy.
Area of Science:
- Urology
- Gastroenterology
- Surgical Pathology
Background:
- Ureteral obstruction is a significant clinical concern, often caused by stones, tumors, or strictures.
- Diverticulitis, an inflammation of colonic diverticula, is typically associated with abdominal pain and changes in bowel habits.
- Rarely, diverticulitis can lead to extrinsic compression of adjacent structures, including the ureter.
Observation:
- A patient presented with a 2-month history of lower left quadrant pain.
- Intravenous pyelogram revealed persistent hydronephrosis, indicating impaired urine flow.
- Surgical exploration identified a fibrotic mass encasing the left ureter and sigmoid colon.
Findings:
- The fibrotic mass was surgically addressed through ureterolysis (freeing the ureter) and segmental sigmoidectomy (removal of a portion of the sigmoid colon).
- Pathological examination of the surgical specimen confirmed the presence of diverticula and subserosal cicatrization (scarring).
- These findings indicate that chronic inflammation from diverticulitis led to fibrotic changes causing ureteral encasement.
Implications:
- This case underscores the importance of considering uncommon causes of ureteral obstruction in patients with relevant gastrointestinal symptoms.
- Early diagnosis and surgical management are crucial for preventing long-term renal damage from obstructive uropathy.
- The findings contribute to the understanding of the spectrum of complications associated with colonic diverticulitis.