Blunt abdominal trauma with an isolated abnormal kidney rupture is a rare clinical entity. The correct preoperative diagnosis may be difficult and challenging because of the insidious onset, lack of obvious bleeding, and, frequently, lack of urinary symptoms.
We present a case of a 22-year-old female with isolated pelvic rupture of a hydronephrotic left kidney secondary to a strong punch in the flank. She underwent a computerized tomography thatshowed a large retroperitoneal collection, with a poor functioning left kidney. Surgical exploration revealed a large rupture of the renal pelvis. She underwent nephrectomy.
Hydronephrosis may be a fortuitous discovery after blunt trauma. The diagnostic features at presentation and the decision-making of surgical management are discussed. The medicolegal aspects of the case are evaluated.
KEYWORDS: Kidney, congenital, renal pelvis, rupture, abdominal trauma, hemorrhage, retroperitoneal space, imputability
CITATION: UroToday Int J. 2012 October;5(5):art 53.