[Spontaneous rupture of the hydronephrotic renal parenchyma associated with urinoma in a child]

Presented is a case report of spontaneous rupture of the renal parenchyma associated with urinoma. A 3-year-old boy had a history of transient gross hematuria followed by sudden onset of left flank pain. Echograms and computed tomographic (CT) scan revealed a left hydronephrotic kidney with perirenal urinoma which had a cyclic change in size corresponding to the pain. Left retrograde pyelogram showed stenosis of the ureteropelvic junction without extravasation of contrast medium. A pin-hole tear was detected in the middle of the left renal parenchyma on exploratory surgery. Left pyeloplasty and retroperitoneal drainage were performed. The postoperative course was satisfactory. Spontaneous rupture of the renal parenchyma, which is frequently caused by renal tumor, vascular disease and/or infection, seems to be seldom caused by increased renal intrapelvic pressure as in rupture of the renal pelvis.