case_images: PMC11263776_01
case_images: PMC11263776_02
case_images: (A) Dynamic 1-minute images, (B) immediate static prevoid, (C) postvoid, and (D) 1-hour delayed images showing tracer accumulation in the kidney and leakage of tracer into perirenal and subsequently into the peritoneal spaces. The nephrostomy drainage bag was seen filled on the right side of the patient (C) which clears in the delayed image (D)
case_images: aojnmb-02-185-g001.jpg
case_images: PMC11263776_02_aojnmb-02-185-g001.jpg
case_images: F1
case_images:  During dynamic phase acquisition and in static images (Figure 1), tracer accumulation was observed in the kidney, and progressive spillover of the tracer was noted into the perirenal and peritoneal spaces.
case_images: (A) Non contrast CT and (B) Fused SPECT CT images showing the collection of tracer in the perirenal space, paracolic gutter, and perihepatic spaces
case_images: aojnmb-02-185-g002.jpg
case_images: PMC11263776_02_aojnmb-02-185-g002.jpg
case_images: F2
case_images:  SPECT/CT images (Figure 2) showed the collection of tracers in the perirenal space, paracolic gutter, and perihepatic spaces.
case_images: PMC11263776_03
case_images: (A) CT image showing contrast in duodenum following contrast injection through percutaneous nephrostomy catheter (exact site of perforation was not delineable but was suspected to be through D2 segment of duodenum). (B) Fused image showing DTPA tracer uptake in pericolic space as well as duodenum and stomach
case_images: aojnmb-02-185-g003.jpg
case_images: PMC11263776_03_aojnmb-02-185-g003.jpg
case_images: F3
case_images: With the help of CT images (Figure 3), following contrast injection through a percutaneous nephrostomy catheter, a diagnosis of a fistulous connection between the para-duodenal collection and duodenum was made, likely through a rent in the lateral wall of the proximal third of D2 segment of the duodenum.