Obstructive urosepsis secondary to ureteric herniation into the sciatic foramen

BMJ Case Rep. 2018 Sep 27:2018:bcr2018225523. doi: 10.1136/bcr-2018-225523.

Abstract

A 65-year-old female patient presented with a 2-day history of worsening right-sided abdominal pain and clinical signs of sepsis, on the background of a recent admission for pancolitis. Imaging revealed right ureteric herniation through the sciatic foramen with subsequent hydroureteronephrosis and radiological signs of severe pyelonephritis. The patient underwent emergency decompression with a percutaneous nephrostomy, followed by insertion of an antegrade stent to correct the ureteric hernia once the sepsis was appropriately treated. We describe the presentation and management of this unusual case of herniation of the right ureter into the sciatic foramen.

Keywords: radiology; renal intervention; urinary and genital tract disorders; urology.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Acute Disease / therapy
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Ciprofloxacin / administration & dosage
  • Female
  • Hernia / complications*
  • Hernia / diagnosis
  • Hernia / therapy
  • Humans
  • Hydronephrosis / etiology
  • Pyelonephritis / etiology
  • Sepsis / etiology*
  • Sepsis / therapy
  • Stents
  • Tomography, X-Ray Computed
  • Ureteral Obstruction / etiology*
  • Ureteral Obstruction / therapy

Substances

  • Anti-Bacterial Agents
  • Ciprofloxacin