Friday, August 29, 2014

What abnormality is shown here in the plain abdominal X-ray of a lady who underwent hysterectomy and then developed recurrent bladder infections with left loin pain?

There are surgical clips on the left side of the pelvis. There isgas in the bladder and a gas pyelogram with air visible in the ureter and in the collecting system of the left kidney (visible behind the stomach gas). These findings are the result of fistulation of the left ureter into the bowel, probably as a result of damage to both during the gynaecological surgery. Treatment is by reimplantation of the ureter and repair of the bowel; at operation, a fistula was found into a loop of small bowel in the pelvis



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