Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney

A 50-year-old patient with a prior history of chronic smoking presented to the emergency department with diffuse abdominal pain, primarily localized to the right hypochondrium and epigastric region, along with nausea, but without fever, vomiting, or urinary symptoms. Laboratory tests were largely un...

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Main Authors: Siham Oukassem, Salma Debbi, Chaima Abourak, Ola Messouad, PhD, Omar EL Aoufir, PhD, Laila Jroundi, PhD, Ali Mohammed Miko, Mamoun Diouri, Ayoub Bouhnib, Ahmed Ibrahimi, PhD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043324013335
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author Siham Oukassem
Salma Debbi
Chaima Abourak
Ola Messouad, PhD
Omar EL Aoufir, PhD
Laila Jroundi, PhD
Ali Mohammed Miko
Mamoun Diouri
Ayoub Bouhnib
Ahmed Ibrahimi, PhD
author_facet Siham Oukassem
Salma Debbi
Chaima Abourak
Ola Messouad, PhD
Omar EL Aoufir, PhD
Laila Jroundi, PhD
Ali Mohammed Miko
Mamoun Diouri
Ayoub Bouhnib
Ahmed Ibrahimi, PhD
author_sort Siham Oukassem
collection DOAJ
description A 50-year-old patient with a prior history of chronic smoking presented to the emergency department with diffuse abdominal pain, primarily localized to the right hypochondrium and epigastric region, along with nausea, but without fever, vomiting, or urinary symptoms. Laboratory tests were largely unremarkable except for isolated hematuria and a mildly elevated CRP. Given the atypical clinical presentation, a 3-phase abdominal CT scan (without contrast, portal, and delayed phases) was conducted, revealing a horseshoe kidney with an obstructing 4 mm stone at the right ureteral meatus. This obstruction led to dilation of the right ureter and renal calyces. In the delayed phase, a rupture of the right calyx was observed with contrast extravasation into the perirenal space. The patient was managed with conservative intervention, including the placement of a JJ stent, analgesics, and antibiotics. The obstructing stone was expelled during stent placement, and the patient showed a favorable clinical course thereafter. Spontaneous rupture of the renal calyx in a horseshoe kidney due to ureteral obstruction by a small calculus is a rare but significant event. Prompt diagnosis with CT imaging and conservative management, including stent placement, can lead to positive outcomes in complex anatomical presentations such as horseshoe kidneys.
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spelling doaj-art-7cff6cd82fad47c9b0aa34d724692ae92025-01-18T05:03:57ZengElsevierRadiology Case Reports1930-04332025-03-0120314861491Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidneySiham Oukassem0Salma Debbi1Chaima Abourak2Ola Messouad, PhD3Omar EL Aoufir, PhD4Laila Jroundi, PhD5Ali Mohammed Miko6Mamoun Diouri7Ayoub Bouhnib8Ahmed Ibrahimi, PhD9Emergency Radiology Department CHU Ibn Sina, Mohamed V University Rabat, Morocco; Corresponding author.Emergency Radiology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoEmergency Radiology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoEmergency Radiology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoEmergency Radiology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoEmergency Radiology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoUrology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoUrology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoUrology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoUrology Department CHU Ibn Sina, Mohamed V University Rabat, MoroccoA 50-year-old patient with a prior history of chronic smoking presented to the emergency department with diffuse abdominal pain, primarily localized to the right hypochondrium and epigastric region, along with nausea, but without fever, vomiting, or urinary symptoms. Laboratory tests were largely unremarkable except for isolated hematuria and a mildly elevated CRP. Given the atypical clinical presentation, a 3-phase abdominal CT scan (without contrast, portal, and delayed phases) was conducted, revealing a horseshoe kidney with an obstructing 4 mm stone at the right ureteral meatus. This obstruction led to dilation of the right ureter and renal calyces. In the delayed phase, a rupture of the right calyx was observed with contrast extravasation into the perirenal space. The patient was managed with conservative intervention, including the placement of a JJ stent, analgesics, and antibiotics. The obstructing stone was expelled during stent placement, and the patient showed a favorable clinical course thereafter. Spontaneous rupture of the renal calyx in a horseshoe kidney due to ureteral obstruction by a small calculus is a rare but significant event. Prompt diagnosis with CT imaging and conservative management, including stent placement, can lead to positive outcomes in complex anatomical presentations such as horseshoe kidneys.http://www.sciencedirect.com/science/article/pii/S1930043324013335Calyceal ruptureHorseshoe kidneyCT scan
spellingShingle Siham Oukassem
Salma Debbi
Chaima Abourak
Ola Messouad, PhD
Omar EL Aoufir, PhD
Laila Jroundi, PhD
Ali Mohammed Miko
Mamoun Diouri
Ayoub Bouhnib
Ahmed Ibrahimi, PhD
Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
Radiology Case Reports
Calyceal rupture
Horseshoe kidney
CT scan
title Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
title_full Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
title_fullStr Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
title_full_unstemmed Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
title_short Rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
title_sort rare case of spontaneous renal calyx rupture due to vesicoureteral junction stone in a horseshoe kidney
topic Calyceal rupture
Horseshoe kidney
CT scan
url http://www.sciencedirect.com/science/article/pii/S1930043324013335
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