Ureteric transection secondary to penetrating handlebar injury.
- Author(s): Debbink, KP;
- Tashjian, DB;
- Tirabassi, MV;
- Gaffey, R;
- Nahmias, J
- et al.
Published Web Locationhttps://doi.org/10.1016/j.tcr.2017.07.002
Ureteric trauma is rare, occurring in < 1% of all traumas. We present a unique case of a 13 year old female who sustained a penetrating abdominal injury from a bicycle handlebar. Upon initial examination there was herniation of bowel through the abdominal wound, so exploratory laparotomy was performed. A serosal injury of the colon and bleeding mesenteric veins were encountered; the retroperitoneum was not explored at that time. Postoperative course was remarkable for a doubling of the serum creatinine, increasing abdominal distention and pain. Computed tomography on postoperative day five demonstrated a large amount of intra-abdominal fluid. The patient was taken for re-exploration. The left ureter was found to be completely transected. It was repaired over a double-J stent. This case demonstrates the need for a high index of suspicion in the diagnosis of ureteric injury.