# Ureterohydronephrosis with rupture of the fornix due to pyelo-ureteral junction syndrome

## TL;DR

A rare case of kidney and ureter rupture caused by a blockage at the pyeloureteral junction is reported, with successful treatment through surgery.

## Contribution

This is the first reported case of renal fornic rupture caused by pyeloureteral junction syndrome.

## Key findings

- A 19-year-old patient presented with kidney rupture due to pyeloureteral junction syndrome.
- The patient's condition improved after laparoscopic surgery and DJ stent removal.
- DTPA scintigraphy confirmed the diagnosis of pyeloureteral junction syndrome.

## Abstract

Rupture of the pyelocalyceal cavities also known as Renal Fornix Rupture (RFR) with urine extravasates into the retroperitoneum is a rare urological complication, most frequently associated with acute urinary tract obstruction induced by a calculus. We here describe an exceptional aetiology of forniceal rupture, i.e. pyeloureteral junction. To our knowledge, this is the first observation reported in the literature of such a complication. Common etiologies responsible for RFR are posterior urethral valves in the neonatal period, prostatic hyperplasia, or traumatic causes, mainly lithiasis. We here report the case of a young 19-year-old patient presenting with febrile low back pain. Uroscanner showed a rupture of the excretory system with extravasation of the contrast medium and large urinoma (A). Clinical and biological outcomes were good with complete regression of the urinoma on a follow-up CT scan (B). Following DJ stent removal, Diethylene-Triamine-Pentaacetate (DTPA) scintigraphy objectified pyelo-ureteral junction syndrome. The patient underwent laparoscopic surgery with favorable outcome (C, D).