PMC5180074_01
CT scan with contrast illustrating vertebral osteophytes extending from L4 and L5 vertebrae encircling ureter. Contrast is seen extravasating into the L4 and L5 disks space and the infrarenal space. Arrow demonstrates contrast extravasating into the L4 and L5 disk space and infrarenal space. UPJ = ureteropelvic junction.
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After transfer, a CT urogram showed extravasation of the contrast into the L4 and L5 disks space and the infrarenal space, indicating ureteral injury approximately 5 cm below the UPJ (Fig. 1).
Retrograde pyelography showing contrast extravasation into L4 and L5 disks space. Arrow demonstrates contrast extravasation into the L4 and L5 disk space.
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Retrograde pyelogram showed extravasation of contrast in the location of the L4 and L5 osteophytes and was again noted to fill the disk space between L4 and L5 (Fig. 2).
Retrograde pyelography showing ureteral stricture that has formed since initial intervention. Arrow demonstrates area of ureteral narrowing and stricture formation.
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During follow-up, retrograde pyelography has confirmed no persistent extravasation, but the region of the ureteral injury has developed a stricture with poor drainage of contrast through the narrowed area (Fig. 3).