PMC5561446_01
Contrast-enhanced computed tomography of the abdomen showing contrast leak at the level of left pelvi-ureteric junction (arrow).
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Contrast enhanced computed tomography of the abdomen revealed gangrenous bowel because of superior mesenteric artery blowout along with laceration of the left PUJ with contained urinary leak (Fig. 1).
(a) Antegrade nephrostogram showing contrast leakage at the left pelvi-ureteric junction (arrow); streak of contrast delineating the upper ureter (asterisk).
(b) Through and through passage of guidewire using the rendezvous technique.
(c) Ureteropelvic drainage catheter across the area of pelvi-ureretic junction transection and well into the ureter.
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While retaining the guidewire into the urinoma, the patient was turned prone and an antegrade percutaneous access was obtained and leak was confirmed (Fig. 2a). A gooseneck snare introduced through the access sheath was used to retrieve the guidewire from the percutaneous sheath to attain a complete through and through access (Fig. 2b). A 16F ureteropelvic drainage catheter was inserted over the guidewire to smoothly bypass the area of injury and was placed into the upper ureter for external drainage (Fig. 2c).