Fig. 7

After PCNL treatment of a 2-cm left renal pelvis stone, a 46-year-old female was not discharged because of a progressive, asymptomatic haemoglobin drop (nadir 8.4 g/dl). Four days later, unenhanced MDCT showed a ureteral stent in place, hyperattenuating (50 HU) circumferential mural thickening of the renal pelvis and proximal ureter (thin arrows in A, B) consistent with suburothelial haemorrhage, and minimal blood in the ipsilateral perirenal and posterior pararenal spaces (arrowhead in A). Study completion with MDCT urography showed a functioning left kidney with a 2-cm devascularised injury (arrow in C) in the dorsal middle third and hypodense suburothelial haemorrhage (thin arrow in C, D) compared to the well-opacified collecting system. Conservative management including blood transfusions allowed hospital discharge in a few days and normalisation of the clinical, biochemical and imaging abnormalities within a month