EP26.02: Optimising care: how accurate diagnosis and imaging‐guided interventions can mitigate postoperative complications

Ureteric injuries are infrequent yet severe consequences of gynecological surgeries, occurring in approximately 0.5% to 1.5% of cases. Failure to promptly diagnose and treat these injuries can have serious health implications for patients. In a recent case, a patient underwent a hysterectomy and subsequently developed abdominal pain and distension. Initial imaging with ultrasound indicated a pelvic hematoma, leading to conservative management. However, as the patient's symptoms progressed, a repeat ultrasound revealed an enlarging hematoma, prompting further investigation with a CT scan. The CT scan showed contrast extravasation from the left renal calyceal system and distal left ureteric obstruction, as well as a right distal ureteric rupture with pooling of contrast into the pelvic collection, indicating bilateral ureteric injury. Treatment for ureteric injuries typically involves a multidisciplinary approach, including percutaneous nephrostomy, ureteric stenting, and drainage of pelvic collections. In this case, these interventions were successful, leading to an overall improvement in the patient's condition. Additionally, surgical procedures were performed to address the ureteric stricture, resulting in a positive postoperative recovery. This case highlights the importance of maintaining a high index of suspicion for ureteric injuries postgynecological surgery and underscores the critical role of prompt recognition and intervention in achieving favourable patient outcomes. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.