Urine Trouble: Forniceal Rupture in the Setting of a Small Urolithic Stone

Fornical ruptures, also known as calyceal ruptures, are a rare sequela of obstructive uropathy in most cases. This pathology can present with similar symptoms to urolithiasis, such as costovertebral tenderness, abdominal pain, nausea, and vomiting. Treatment of forniceal ruptures can vary based on the individual clinical presentation. It may be conservative with hydration, intravenous antibiotics, and pain control. It can also involve more invasive interventions such as stent placement, nephrostomy tube placement, and fluid aspiration. We present a patient with no history of urolithiasis, trauma, malignancy, or previous urologic interventions, who was found to have an obstructive uropathy by a three-millimeter stone that led to a right-sided forniceal rupture by computed tomography imaging. The patient was admitted to the general medical service with urology following for intravenous antibiotics, stent placement with cystoscopy, and lithotripsy.