PMC3914124_01
Computerized tomography (CT) of abdomen revealed (a) mild right hydronephrosis and hydroureter at initial presentation and (b) a big hypovascular tumor in lower abdomen area, with bowel loop right shifting. Multiple enlarged LNs were also noted at para-aortic region.
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An emergent abdominal CT showed a big hypovascular tumor located in the lower abdomen, right hydronephrosis, and multiple enlarged para-aortic LNs (Figures 1(a) and 1(b)).
Due to persistent fluid discharge postoperatively, further abdominal CT revealed fluid collection within the abdominal cavity. A percutaneous drainage was inserted and massive pus-like fluid was drained.
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A percutaneous drainage was inserted postoperatively because of persistent large amount fluid discharge from abdominal cavity (Figure 2).
Right percutaneous nephrostomy (PCN) was inserted by radiologist due to progressive right hydronephrosis. Antegrade pyelography (prone position) revealed right upper third ureteral stricture at L5 level with mild to moderate hydronephrosis.
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Antegrade pyelography found an upper ureteral stricture with contrast leakage (Figure 3).
Patient underwent a definite Boari flap for the ureteroneocystostomy to release right ureteral stricture. Postoperative antegrade pyelography revealed neither ureteral stricture nor contrast medium leakage from the anastomosis site.
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The post-operative course was smooth, and the following antegrade pyelography revealed patent of ureter (Figure 4).