Ureteral injuries: CT diagnosis

Ureteral injury is a rare, yet very serious, complication of various abdominal, pelvic, and even spinal procedures. It is often clinically unsuspected as symptoms are nonspecific and the patient may present weeks and even months after the injury. Therefore the diagnosis of ureteral injury is often delayed, leading to more serious morbidity. A ureteral injury may be first diagnosed on CT in a patient evaluated after surgery. A high index of suspicion is essential and a CT study should then include a delayed scan in order to establish the diagnosis of ureteral injury resulting in a urinoma. This may obviate the need for additional invasive imaging studies or unnecessary exploration.