International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 3, Issue 12 | Case Report | Open Access DOI
Daniel Savio Magee*
Urology Department of Royal Perth Hospital, Western Australia, Australia
*Correspondence to: Daniel Savio Magee
Fulltext PDFBackground: Spontaneous ureteric rupture is an exceedingly rare complication, particularly in the context of an unremarkable obstetric history. We report a case of a nulliparous 19-year-old who sustained a spontaneous right proximal ureteric rupture intrapartum during a spontaneous vaginal delivery (SVD).
Case Presentation: The patient 60 hours postpartum developed persistent and worsening right iliac fossa pain. She had no prior history of genitourinary pathology. Initial clinical assessment prompted imaging, and a delayed-phase computed tomography intravenous pyelogram (CT IVP) revealed a proximal ureteric leak with the formation of a urinoma. The patient was hemodynamically stable and commenced on prophylactic antibiotics. She was subsequently transferred to a tertiary care centre for urological intervention.
Endoscopic intervention involved the insertion of a right sided JJ stent under radiological guidance. The patient recovered well post-procedure and was discharged in stable condition the same day. A repeat right-sided retrograde pyelogram under general anaesthesia at 6 weeks post stenting confirmed healing of the ureteric injury, with no evidence of ongoing urinary leakage.
Conclusion: This case highlights a rare but significant complication of SVD, emphasizing the importance of timely diagnosis and multidisciplinary management in achieving favourable outcomes. Despite its rarity, spontaneous ureteric rupture should be considered in postpartum patients presenting with persistent abdominal pain and potentially fever, particularly when imaging reveals evidence of free fluid within the abdomen.
Spontaneous ureteric rupture; Vaginal delivery; Postpartum complication; Urinoma; Endoscopic intervention; JJ stent
Daniel Savio Magee. Right Ureteric Rupture During Spontaneous Vaginal Delivery: A Rare Case Report. Int Clinc Med Case Rep Jour. 2024;3(12):1-4.