Spontaneous Ureteral Rupture and Urinoma: A Delayed CT Diagnosis That Radiologists Must Not Miss
How Delayed CT Imaging Reveals Hidden Urinary Leakage and Prevents Missed Emergency Diagnoses Edited by ScholarGen MediAI Team Executive Clinical Summary A patient presented with persistent left-sided abdominal pain. Initial CT imaging demonstrated delayed nephrogram, proximal ureteral dilatation, and retroperitoneal fluid collection without a visible obstructing stone. The diagnosis remained uncertain until delayed excretory-phase CT revealed contrast extravasation into the retroperitoneal space—confirming spontaneous ureteral rupture with urinoma formation . This case reinforces a fundamental radiologic principle: Urinary leakage cannot be diagnosed without delayed-phase imaging. Clinical Hook The CT scan appears inconclusive. No stone is identified. Yet the kidney enhances asymmetrically. The ureter is subtly dilated. There is unexplained fluid in the retroperitoneum. At that moment, the diagnosis depends not on what is seen— but on what the radiologist chooses t...
