Spontaneous Rupture of the Ureter Secondary to Urolithiasis and Extravasation of Calyceal Fornix due to Acute Urinary Bladder Distension: four cases report

Spontaneous rupture of the ureter is extremely uncommon and thought as a nontraumatic leakage of the urine from the ureter. It is usually secondary to ureteral obstruction from a calculus. The symptom is always severe and drainage or surgical intervention is often required. True rupture of upper ureter or renal pelvis may be confused with a physiologic phenomenon of the forniceal rupture with urine extravasation. Forniceal extravasation is also mainly due to ureteral stone. In contrast to ureteral rupture, forniceal extravasation is more commonly seen and the symptom is always mild. Conservative management is the principle of treatment. A clear distinction between these two conditions becomes very important since both course and treatment are different. We present 3 cases of rare spontaneous rupture of the ureter with calculus disease and a case of forniceal extravasation unusually due to acute urinary bladder distension. Difference between these two conditions is discussed.