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Extra-renal rupture of a cortical cyst with subsequent perinephric hematoma

Case contributed by Saeed Soltany Hosn
Diagnosis possible

Presentation

Patient comes to the emergency department complaining of severe right flank pain. He reports that the pain began approximately 4 hours ago. No history about trauma or prior drug use.

Patient Data

Age: 45-50 year
Gender: Male

Three phase contrast enhanced CT scan shows antero-superior displacement of the right kidney by high density perinephric hematoma associated with multiple(bilateral) cortical cysts.There is no evidence of active contrast extravasation. No contrast within the perinephric collection on the excretory phase images to suggest a urinoma. There is also abdominal free fluid. The ruptured cyst is clearly delineated in the upper pole of the right kidney (arrow) 

Case Discussion

Beacuse there is no evidence of a distinct mass whitin the renal paranchyma,the most probable cause is, extra renal rupture of a simple cyst.

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