Delayed Diagnosis of Ureteral Injury Following Penetrating Abdominal Trauma: A Case Report and Review of the Literature.

Content Provider	Europe PMC
Author	Taqi, Kadhim M. Nassr, Manar Mohammed Jufaili, Jihad Salim Al Abu-Qasida, Alla Ibrahim Mathew, Joseph Al-Qadhi, Hani
Copyright Year	2017
Abstract	Patient: Female, 29Final Diagnosis: Missed ureteral injurySymptoms: Abdominal pain • anemia • fever • loose stoolsMedication: —Clinical Procedure: UreteroureterostomySpecialty: UrologyObjective:Mistake in diagnosisBackground:Ureteral injuries are considered to be uncommon in cases of trauma. The possibility of damage to the ureters may not be considered in the setting of acute trauma when life-threatening injuries take clinical management priority. A case of acute ureteral injury is described in a patient with acute penetrating gunshot abdominal injury that had a delay in diagnosis, with a review of the literature.Case Report:A29-year-old woman presented to our hospital with a missed ureteral injury following a self-inflicted gunshot injury to the abdomen. She underwent abdominal computed tomography (CT) imaging and a retrograde pyelogram, which showed complete transection of the left upper ureter with contrast extravasation and the formation of a large urinoma. She underwent a percutaneous nephrostomy and drainage of the urinoma. An end-to-end ureteric anastomosis with excision of the intervening injured ureter, or ureteroureterostomy, was performed three weeks following the diagnosis.Conclusions:Ureteral injuries following trauma are rare, but a delay in diagnosis can be associated with clinical morbidity. A high index of clinical suspicion is important for early identification of ureteral injury in cases of acute abdominal trauma.
Volume Number	18
PubMed Central reference number	PMC5747955
PubMed reference number	29273706
Journal	The American Journal of Case Reports [Am J Case Rep]
e-ISSN	19415923
DOI	10.12659/AJCR.905702
Language	English
Publisher	International Scientific Literature, Inc.
Publisher Date	2017-12-23
Access Restriction	Open
Rights License	This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) © Am J Case Rep, 2017
Subject Keyword	Abdominal Injuries Ureter Wounds, Gunshot
Content Type	Text
Resource Type	Article
Subject	Medicine