PMC6555170_01
Coronal section of CT showing perforation (arrow) of the bladder wall with surrounding fluid collection.
fig-1.jpg
PMC6555170_01_fig-1.jpg
f1
The bladder was grossly distended with evidence of extraperitoneal fluid (Fig. 1).
Coronal section of CT showing right nonfunctioning kidney (cross) with left retroperitoneal collection (arrow).
fig-2.jpg
PMC6555170_01_fig-2.jpg
f2
The left functional kidney was enlarged consistent with compensatory hypertrophy, with a hydroureter (down to the level of the ureteral orifice) and hydronephrosis, with a multiloculated retroperitoneal collection suggesting secondary pelvicaliceal rupture (Fig. 2).
Left nephrostogram showing extravasation of contrast (arrow) with pelvicaliceal outline (cross) but no delineation of the ureter.
fig-3.jpg
PMC6555170_01_fig-3.jpg
f3
The ureter was not delineated on this study (Fig. 3).
CT urogram showing stent (red arrow pointing to top end in dilated pelvis and yellow arrow to lower end in the bladder) in the baggy, distended system with no retroperitoneal collection.
fig-4.jpg
PMC6555170_01_fig-4.jpg
f4
Terumo hydrophilic guidewire was passed down to the bladder through an antegrade approach into the bladder and a stent (6F/26 cm) was secured in the left ureter (Fig. 4).
Retrograde study showing a tortuous dilated ureter (red arrow) and a baggy renal pelvis (blue arrow).
fig-5.jpg
PMC6555170_01_fig-5.jpg
f5
This was confirmed on cystogram and retrograde study (Fig. 5).