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

Abstract BACKGROUND 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 A 29-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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american journal of case reports
Publication Year Start




PMID- 29273706
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20180105
IS  - 1941-5923 (Electronic)
IS  - 1941-5923 (Linking)
VI  - 18
DP  - 2017 Dec 23
TI  - Delayed Diagnosis of Ureteral Injury Following Penetrating Abdominal Trauma: A
      Case Report and Review of the Literature.
PG  - 1377-1381
AB  - BACKGROUND 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 A 29-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.
FAU - Taqi, Kadhim M
AU  - Taqi KM
AD  - Department of General Surgery, Sultan Qaboos University Hospital, Muscat, Oman.
FAU - Nassr, Manar Mohammed
AU  - Nassr MM
AD  - Department of General Surgery, Oman Medical Specialty Board, Muscat, Oman.
FAU - Al Jufaili, Jihad Salim
AU  - Al Jufaili JS
AD  - Department of Orthopedic Surgery, Oman Medical Specialty Board, Muscat, Oman.
FAU - Abu-Qasida, Alla Ibrahim
AU  - Abu-Qasida AI
AD  - Department of General Surgery, Oman Medical Specialty Board, Muscat, Oman.
FAU - Mathew, Joseph
AU  - Mathew J
AD  - Department of General Surgery, Sultan Qaboos University Hospital, Muscat, Oman.
FAU - Al-Qadhi, Hani
AU  - Al-Qadhi H
AD  - Department of General Surgery, Sultan Qaboos University Hospital, Muscat, Oman.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20171223
PL  - United States
TA  - Am J Case Rep
JT  - The American journal of case reports
JID - 101489566
SB  - IM
MH  - Abdominal Injuries/*complications
MH  - Adult
MH  - Delayed Diagnosis
MH  - Female
MH  - Humans
MH  - Ureter/*injuries
MH  - Wounds, Gunshot/*complications
PMC - PMC5747955
EDAT- 2017/12/24 06:00
MHDA- 2018/01/05 06:00
CRDT- 2017/12/24 06:00
PHST- 2017/12/24 06:00 [entrez]
PHST- 2017/12/24 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
AID - 905702 [pii]
PST - epublish
SO  - Am J Case Rep. 2017 Dec 23;18:1377-1381.