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Foreign Body Ingestion Resulting in Hydronephrosis
IMAGES IN IR
Foreign Body Ingestion Resulting in Hydronephrosis Raja S. Ramaswamy, MD, and Andrew C. Picel, MD
Figure 1
Figure 3
Figure 2
Figure 4
A 90-year-old woman presented to the emergency department with lower abdominal pain. A computed tomography (CT) scan of the abdomen and pelvis demonstrated poor enhancement and moderate hydronephrosis of the right kidney (arrow in Fig 1). A curved planar reformatted CT image showed a linear foreign body piercing the colon wall and entering the right ureter (arrow in Fig 2). The ureter was dilated with surrounding inflammation. The patient subsequently developed urosepsis, and a right percutaneous nephrostomy tube was
placed to relieve the obstruction. An antegrade pyelogram showed tapering of the midureter (arrow in Fig 3) with edema in the region of the injury resulting in a long segment stricture. Endoscopy was performed, and a 6-cm wood toothpick (arrow in Fig 4) was seen penetrating the colon wall. The ingested foreign body was removed without complication. A follow-up nephrostogram obtained 3 weeks later demonstrated resolution of the ureteral stricture, and the percutaneous nephrostomy was successfully removed.
From the Department of Radiology, University of California, San Diego, 200 West Arbor Drive, San Diego, CA 92130-8756. Received and accepted November 15, 2014. Address correspondence to R.S.R.; E-mail: [email protected]
& SIR, 2015
Neither of the authors has identified a conflict of interest.
J Vasc Interv Radiol 2015; 26:679 http://dx.doi.org/10.1016/j.jvir.2014.11.022
Foreign Body Ingestion Resulting in Hydronephrosis Raja S. Ramaswamy, MD, and Andrew C. Picel, MD
Figure 1
Figure 3
Figure 2
Figure 4
A 90-year-old woman presented to the emergency department with lower abdominal pain. A computed tomography (CT) scan of the abdomen and pelvis demonstrated poor enhancement and moderate hydronephrosis of the right kidney (arrow in Fig 1). A curved planar reformatted CT image showed a linear foreign body piercing the colon wall and entering the right ureter (arrow in Fig 2). The ureter was dilated with surrounding inflammation. The patient subsequently developed urosepsis, and a right percutaneous nephrostomy tube was
placed to relieve the obstruction. An antegrade pyelogram showed tapering of the midureter (arrow in Fig 3) with edema in the region of the injury resulting in a long segment stricture. Endoscopy was performed, and a 6-cm wood toothpick (arrow in Fig 4) was seen penetrating the colon wall. The ingested foreign body was removed without complication. A follow-up nephrostogram obtained 3 weeks later demonstrated resolution of the ureteral stricture, and the percutaneous nephrostomy was successfully removed.
From the Department of Radiology, University of California, San Diego, 200 West Arbor Drive, San Diego, CA 92130-8756. Received and accepted November 15, 2014. Address correspondence to R.S.R.; E-mail: [email protected]
& SIR, 2015
Neither of the authors has identified a conflict of interest.
J Vasc Interv Radiol 2015; 26:679 http://dx.doi.org/10.1016/j.jvir.2014.11.022