title: Spontaneous renal forniceal rupture due to advanced cervical carcinoma with obstructive uropathy.
abstract: OBJECTIVE
  To report and describe the clinical presentation and outcome of a woman presenting with gross perinephric urinary extravasation (due to spontaneous renal forniceal rupture), secondary to malignant obstructive uropathy caused by advanced cervical carcinoma. To review the etiopathogenesis, approach to diagnosis and management of 'spontaneous renal forniceal rupture.
  
  
  METHODS
  The published English literature (PubMed) was searched for similar cases of 'spontaneous renal forniceal rupture' using the keywords: carcinoma cervix, metastatic carcinoma cervix, renal pelvis rupture, renal fornix rupture, spontaneous renal fornix rupture and urinoma.
  
  
  RESULTS
  The diagnosis of renal forniceal rupture with gross urinoma formation secondary to advanced cervical carcinoma was suspected on ultrasound and was subsequently confirmed by a computed tomographic scan of the abdomen. Percutaneous nephrostomy with a pigtail catheter resolved the urinoma. Search results for similar cases yielded several causes of spontaneous renal forniceal rupture, however, only one such case report due to advanced cervical carcinoma was found.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the second case of spontaneous renal forniceal rupture secondary to ureteral obstruction caused by advanced cervical carcinoma to be reported in the published English literature. A high clinical index of suspicion is warranted in any patient of advanced cervical carcinoma that presents with sudden uremia or oliguria with flank pain and swelling in order to arrive at an early diagnosis. A decompressive nephrostomy may provide the much needed comfort and succor towards prolonging the life of such unfortunate patients.
authors.affiliation: Department of Surgery, UCMS and GTBH, New Delhi, India. iqbalsinghp@yahoo.co.uk
authors.forename: Iqbal
authors.initials: I
authors.lastname: Singh
authors.forename: Mohit
authors.initials: M
authors.lastname: Joshi
authors.forename: Gopesh
authors.initials: G
authors.lastname: Mehrotra
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000150:complications*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D012422:Rupture, Spontaneous / Q000209:etiology; D053584:Urinoma / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000150:complications*