Ureteral Intraluminal Dissection Caused by Spontaneous Ureteropelvic Rupture: A Rare Case Report and Review of the Literature

Abstract

Introduction: Spontaneous ureteropelvic rupture (SUPR) is rare, and its combination with ureteral intraluminal dissection (UID) is even rarer. Case Presentation: A 62-year-old Chinese man was admitted to the hospital with acute, severe right lumbar pain accompanied by nausea and vomiting. Contrast-enhanced computed tomography of the abdomen and pelvis showed a double-lumen appearance and septum formation in the middle and upper segments of the right ureter during the excretory phase. Based on these imaging findings, UID caused by SUPR was diagnosed. The patient was managed conservatively with antibiotics for three weeks without ureteral stenting. Conclusion: This case involved SUPR combined with UID; however, the source remained elusive. Limited clinical awareness and variable clinical manifestations often make the diagnosis challenging. Diagnosis relies on delayed contrast-enhanced computed tomography (CT) of the abdomen and pelvis. Currently, no standardized guidelines are available, and minimally invasive endourological approaches are generally accepted as the preferred first-line option.