Abstract:
Introduction and importance: Generalized peritonitis following proximal ureteral rupture is a very rare compli-
cation. This is about a successfully managed case without open surgical intervention.
Case presentation: A lady in her 70s presented with generalized abdominal pain, high spiking fever and low urine
output for 3 days. She was haemodynamically unstable on admission and was resuscitated and managed at
intensive care unit. CECT abdomen revealed partial anterior ureteral rupture with pyonephrosis. She was
managed with percutaneous nephrostomy and subsequent anterograde stenting. Her recovery was uneventful
and follow up imaging revealed no features of malignancy.
Clinical discussion: Generalized peritonitis due to renal pathology is very rare and it can be due to urolithiasis or
neoplasm. Retroperitoneal infections may lead to irritation of peritoneum or fistulation into the peritoneum
leading to generalized peritonitis. This can be managed by various surgical and non-surgical management
modalities.
Conclusion: There are various pathological causes for acute abdomen. One of the rare causes is spontaneous
rupture of ureter in pyonephrotic kidney which can also be managed successfully with minimal intervention.
