Spontaneous ureteric rupture during medical expulsive therapy for distal ureteric calculus: A case report

Spontaneous ureteric rupture is a rare complication of ureteric calculi that requires a high index of suspicion for timely diagnosis and management. We report a 38-year-old man who developed spontaneous rupture of the right ureter during medical expulsive therapy for a distal ureteric calculus. Contrast-enhanced computed tomography in the delayed excretory phase demonstrated contrast extravasation with a periureteric urinoma. The patient was successfully managed with percutaneous nephrostomy, followed by delayed ureteric stenting after confirmation of spontaneous healing on antegrade nephrostogram. The stent was subsequently removed. At approximately 1-year follow-up the patient remained asymptomatic, with no complications. Early recognition and timely urinary diversion can achieve excellent outcomes while avoiding major reconstructive surgery.