PMC6220595_01
(a) Right hydronephrosis with a large well-defined collection in retropancreatic region extending along precaval and aortocaval region (urinoma). Arrow shows large urinoma which raises the concern of ureteric injury. (b) Contrast leak from the pelviureteric junction. Arrow confirms the source of urinary leak.
fig-1.jpg
PMC6220595_01_fig-1.jpg
f1
Contrast-enhanced CT was done at the referral hospital and it showed right hydronephrosis with a large well-defined collection in retropancreatic region extending along precaval and aortocaval region (urinoma), with a contrast leak from the pelviureteric junction (PUJ) (Fig. 1).
A simultaneous antegrade and retrograde pyelogram showing a long-segment (4 cm) upper ureteral defect. Abrupt contrast cut-off in renal pelvis and upper ureter highlighting the ureteric defect (arrow).
fig-2.jpg
PMC6220595_01_fig-2.jpg
f2
A simultaneous antegrade and retrograde pyelogram were done under anesthesia (Fig. 2).
Robotic ureterocalicostomy being done with Double-J stent (*) in position. Site of ureterocalicostomy with Double-J stent across the anastomotic site (arrow).
fig-3.jpg
PMC6220595_01_fig-3.jpg
f3
The dissected upper end of ureter was splayed and a tension-free and water-tight ureterocalicostomy was completed after placing a Double-J stent (Fig. 3).
Intravenous pyelography done after 4 months, showing good drainage of contrast across the ureterocalicostomy site (arrow).
fig-4.jpg
PMC6220595_01_fig-4.jpg
f4
Intravenous pyelography was done after 4 months (Fig. 4), which shows an intact ureterocalicostomy anastomosis and good drainage of contrast.