Rotura espontânea bilateral das vias coletoras, por cálculo de ureter / Spontaneous bilateral urinary tract rupture due to ureteral calculi

RESUMO

A rare case of bilateral ureteral lithiasis associated with bilateral rupture of the urinary tract in a 34-year-old male is presented. The patient was admitted with renal failure and bilateral retroperitoneal urinoma. An endoscopic approach with bilateral ureteral catheterization with a double-J stent was used. After stabilization of renal failure and complete reabsorption of the urinoma, extracorporeal shock wave lithtripsy with was performed the stents in place. After 2 months, both stents were removed and the stones have been completely eliminated. Urinary lithiasis and ureteral tumors are the most common causes of urinary rupture. Emergency drainage of the urinary tract may be necessary. Urinoma often has a spontaneous absorption. It is unwise to attempt extraction of stones in patients with bilateral obstruction and acute renal failure as this can lead to serious complications. The renal failure must be resolved first and the stones managed afterwards