Abstract
A 77-year-old woman with no history of urinary tract stones, urological disorder, or trauma presented to our hospital
with complaints of persistent right flank pain accompanied by nausea. Initial blood tests revealed mildly elevated inflammatory
markers but no definitive abnormalities. A contrast-enhanced computed tomography (CT) scan revealed
retroperitoneal fluid accumulation, raising suspicion of urine leakage. A follow-up CT scan taken 4 h later confirmed
extravasation of contrast medium, establishing the diagnosis of spontaneous ureteric rupture without ureteral obstruction.
The patient underwent retrograde pyelography (RP), which identified the rupture site at the ureteropelvic junction.
A ureteral stent was placed, and intravenous antibiotics were administered, resulting in full recovery. This case
emphasizes the importance of considering ureteric rupture in cases of acute abdomen with unexplained fluid accumulation.
Because elderly patients may experience delayed contrast excretion, repeat CT scans at appropriate intervals
are recommended for accurate diagnosis. This case also highlights the dual diagnostic and therapeutic value of RP,
emphasizing the need for timely urologist referral in emergency settings where specialist access may be limited.
