Spontaneous Rupture of the Renal Pelvis Secondary to Upper Tract Urothelial Carcinoma

Spontaneous rupture of the renal pelvis is a rare case of urologic emergency. In almost all instances, it occurs as a result of obstruction of the urinary tract, leading to increased pelvic pressure, most often caused by a calculus. We present a case of a 71-year-old male with flank and abdominal pain. Rupture of the renal pelvis with urohematoma was suspected, but the etiology was unknown. Imaging, retrograde ureteropyelograhy, and flexible ureterorenoscopy couldn't find the underlying cause for the suspected renal pelvis rupture, and a subsequent explorative surgery was needed in order to establish a diagnosis. Treatment included radical nephroureterctomy with bladder cuff excision. Cystoscopy and PET/CT were performed as a follow-up. No evidence of disease recurrence was found.