Renal pelvis rupture presenting as an acute abdomen in patient with Alzheimer’s dementia: a case report and literature review

Renal pelvis rupture (RPR) with clinical presentation of acute abdomen is an unusual clinical event and in a patient with Alzheimer's dementia is unique in its clinical presentation and differentiating the diagnosis. We report a case of a 75-year-old male Alzheimer's patient who complained of sudden right-sided flank and abdominal pain followed by nausea, and vomiting, without a history or signs of external trauma. Abdominal ultrasound showed fluid collection close to the right renal pelvis with first-grade hydronephrosis. Computed tomography revealed right colon overdistension and, a 2 mm proximal right ureteral stone, and contrast urography showed a dilated right renal pelvis with extravasation. After the endoscopic treatment with double-J stent, no contrast extravasation was seen on the control CTU, and the stent was removed after four weeks. Patients with Alzheimer's dementia presenting with acute abdomen and flank pain should be evaluated for renal pelvis rupture with prompt diagnosis and management.