Spontaneous Rupture of the Renal Pelvis During Pregnancy: A Case Report and Review of the Literature

ABSTRACT

We report a case with spontaneous rupture of the renal pelvis during pregnancy. A 34-year-old Japanese woman was referred at 20 weeks' gestation because of sudden severe right flank pain. She had severe colic pain radiating to the right lower abdomen with percussion tenderness at the right costovertebral angle and was initially suspected to have renal/ureteral calculi. Ultrasonography and intravenous pyelography showed urine extravasating from the renal pelvis, indicating rupture of the right renal pelvis. Immediately following the insertion of a double-J indwelling catheter, her symptoms and perirenal extravasation ceased. She had no further urological problems during pregnancy and a male infant was delivered at 41 weeks' gestation. Cases with spontaneous rupture of the renal pelvis in pregnancy are reviewed.

KEYWORDS

Rupture of the renal pelvis - pregnancy - extravasation

REFERENCES

• 1 Meyers S J, Lee R V, Munschauer R W. Dilatation and nontraumatic rupture of the urinary tract during pregnancy: a review.  Obstet Gynecol . 1985;  66 809-815
• 2 van Winter T J, Ogburn Jr L P, Engen D E, Webb M J. Spontaneous renal rupture during pregnancy.  Mayo Clin Proc . 1991;  66 179-182
• 3 Andriole G L, Bettmann M A, Garnick M B, Richie J P. Indwelling double-J ureteral stents for temporary and permanent urinary damage: experience with 87 patients.  J Urol . 1984;  131 239-241
• 4 Campbell I C. A case of spontaneous extra- and intraperitoneal rupture of a hydronephrosis in pregnancy.  J Obstet Gynaecol Br Commonw . 1947;  54 853-854
• 5 Rusche C. Renal hamartoma (angiomyolipoma): report of three cases.  J Urol . 1952;  67 823-831
• 6 Chamblin W D, Marine W C. Massive retroperitoneal hemorrhage complicating pregnancy.  Am J Obstet Gynecol . 1956;  72 680-682
• 7 Jeppesen F B. Spontaneous rupture of the kidney.  J Urol . 1961;  86 489-492
• 8 Kiser D M, McGannon P T, Sinclair A B. Massive retroperitoneal hemorrhage from spontaneous rupture of hamartoma of the kidney in pregnancy.  Am J Obstet Gynecol . 1964;  88 545-546
• 9 Cohen S G, Pearlman C K. Spontaneous rupture of the kidney in pregnancy.  J Urol . 1968;  100 365-369
• 10 Bruce A W, Awad S A. Spontaneous rupture of the kidney in pregnancy.  J Urol . 1966;  95 5-7
• 11 Aaro L A, Kelalis P P. Spontaneous rupture of the kidney associated with pregnancy.  Am J Obstet Gynecol . 1971;  111 270-273
• 12 Middleton Jr W A, Middleton G W, Dean L K. Spontaneous renal rupture in pregnancy.  Urology . 1980;  15 60-63
• 13 Maresca L, Koucky C J. Spontaneous rupture of the renal pelvis during pregnancy presenting as acute abdomen.  Obstet Gynecol . 1981;  58 745-747
• 14 Kramer R L. Urinoma in pregnancy.  Obstet Gynecol . 1983;  62(suppl) 26-28
• 15 Oesterling J E, Besinger R E, Brendler C B. Spontaneous rupture of the renal collecting system during pregnancy: successful management with a temporary ureteral catheter.  J Urol . 1988;  140 588-590
• 16 Kretschmer H L, Heaney N S. Dilatation of the ureters, kidney and pelvis during pregnancy.  JAMA . 1925;  85 406-409
• 17 Pitkin R M. Morphologic changes in pregnancy. In: Buchsbaum HJ, Schmidt J, eds. Gynecologic and Obstetric Urology Philadelphia: Saunders 1978: 375-379