Spontaneous Fornix Rupture Due to Obstructive Ureteral Stone

Spontaneous rupture of the renal fornix and urinary extravasation are very rarely encountered in urological practice. In the present paper, a 57-year-old male patient who suddenly developed spontaneous rupture of the fornix and urinary extravasation due to obstructive ureteral stone is presented. The patient developed a sudden onset of renal colic pain without any trauma. His complete blood count and kidney function tests were within the normal limits. Microscopic hematuria was detected on complete urinalysis. There was no urinary opacity on plain X-ray. On urinary ultrasonography, the left renal pelvis and ureter were dilated and there was a hyperechoic appearance consistent with a stone approximately 4 mm in diameter at the distal end of the left ureter. Grade 1 dilatations of the left renal pelvis and ureter and extravasation of contrast material at the peripelvic area were observed on intravenous pyelography. Spiral computed tomography also showed extravasation of contrast material in the left pararenal area. In the present case, double J stent catheterization was performed in order to control symptoms and eliminate extravasation. His postoperative pain decreased and alpha-blocker treatment was initiated at the follow-up. Extravasation regressed and hydronephrosis disappeared on follow-up ultrasounds. Two weeks later, the patient stated that he had passed the stone. The catheter was withdrawn and the patient was discharged on the same day.