A 58-year-old male patient was referred to the imaging service by the urologist for a diagnosis of microhaematuria, with no known personal or family morbid history.
She had no history of allergies or previous contrast reactions.
After intravenous contrast administration, the patient complained of severe low back pain.
The examination was suspended and taken to the emergency service for evaluation.
Low back pain, mild tachycardia, eupneic, with normal blood pressure was confirmed.
She was treated with intravenous analgesics and the pain was severe.
He also urinated normally without macroscopic hematuria.
Creatininemia was 1.15 mgr/dl.
As the urotac is a CT scan oriented mainly to the evaluation of the kidney and urinary tract, it is necessary to first perform the study without contrast, then a phase at 70 seconds to enhance the renal parenchyma and a late phase.
Therefore, our patient was taken again to tomography to perform the elimination phase of the examination.
At this moment, bilateral rupture of the excretory system was verified.
She was hospitalized for observation.
Urotac was normal until the venous phase of the study.
Vascular malformations and ureters showed no abnormalities.
However, in the elimination phase taken after the patient was again treated for acute low back pain, she showed leakage of contrast from the excretory system to the retroperitoneum with formation of moderate ruptured urinureal skin.
Hydronephrosis was not observed and both ureters were of normal caliber distally.
No calcified calculi were identified either.
The bladder walls are closed with a ureteral-vesical system.
Normal size prostate.
1.
At the 24-hour follow-up, the patient was hemodynamically stable, without pain, with a hematocrit of 44.8 and a hemoglobin of 15.4, ESR of 2, leukocytes 12,000 with 86% segmented and 0% bacilliform.
The urine test was normal, with 8-10 erythrocytes per field.
The creatinine level was 0.75 mgr/dl. The patient was discharged with outpatient follow-up.
The patient was controlled after 15 days.
He was in good condition and had no difficulty in obtaining or obtaining approval.
Skin was removed and showed both morphologically normal kidneys, with no dilatation of excretory systems or calculi and total reabsorption of the extravasated contrast into the retroperitoneum.
Urinary sediment was normal, with 4 to 6 erythrocytes x field and 0 to 2 leukocytes x field, without crystals.
Creatininemia was 0.82 mgr/dl.
