Date of Presentation

5-6-2021 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Flank pain, abdominal pain and hematuria are common complaints in emergency medicine. We describe the case of a 72-year-old female who presented to the emergency department for worsening left lower quadrant abdominal pain and left flank pain associated with new-onset hematuria. The patient reports the pain started immediately after she accidentally tripped on a rock while trying to avoid a mailman in an attempt to socially distance due to the COVID-19 pandemic, which resulted in a forceful twist of her body and catching herself with her hands without any direct impact to her body. The patient reports the pain gradually got worse and she tried to ice her abdomen without much relief. The first CT abdomen with contrast that the patient received in the emergency department showed some hydronephrosis of the left kidney suggestive of an obstructive pathology and a small collection of perirenal fluid by the left kidney without evidence of any nephrolithiasis. Due to the nature of the patient’s history, we decided to get a delayed contrast enhanced CT, which ultimately showed evidence of left kidney rupture with leakage of the contrast dye through the left renal calyx and out around the left kidney and down into the lower part of the abdomen and musculature. The pain the patient was experiencing was due to a left kidney rupture, likely traumatic in nature as the patient performed a forceful twist with her body, and irritation of all surrounding structures where her urine was leaking out into her body outside the kidney itself.

Keywords

kidney, hematuria, wounds and injuries, rupture, abdominal injuries

Disciplines

Emergency Medicine | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms | Urogenital System | Urology

Document Type

Poster

COinS
 
May 6th, 12:00 AM

Kidney Rupture: An Unusual Cause of Abdominal Pain, Flank Pain and Hematuria in a 72-Year-Old Female

Flank pain, abdominal pain and hematuria are common complaints in emergency medicine. We describe the case of a 72-year-old female who presented to the emergency department for worsening left lower quadrant abdominal pain and left flank pain associated with new-onset hematuria. The patient reports the pain started immediately after she accidentally tripped on a rock while trying to avoid a mailman in an attempt to socially distance due to the COVID-19 pandemic, which resulted in a forceful twist of her body and catching herself with her hands without any direct impact to her body. The patient reports the pain gradually got worse and she tried to ice her abdomen without much relief. The first CT abdomen with contrast that the patient received in the emergency department showed some hydronephrosis of the left kidney suggestive of an obstructive pathology and a small collection of perirenal fluid by the left kidney without evidence of any nephrolithiasis. Due to the nature of the patient’s history, we decided to get a delayed contrast enhanced CT, which ultimately showed evidence of left kidney rupture with leakage of the contrast dye through the left renal calyx and out around the left kidney and down into the lower part of the abdomen and musculature. The pain the patient was experiencing was due to a left kidney rupture, likely traumatic in nature as the patient performed a forceful twist with her body, and irritation of all surrounding structures where her urine was leaking out into her body outside the kidney itself.

 

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