Radiology, Vol 160, 99-103, Copyright © 1986 by Radiological Society of North America
Spontaneous and traumatic rupture of renal cysts: diagnosis and outcome
N Papanicolaou, RC Pfister and IC Yoder
Twenty-five patients with spontaneous or traumatic rupture of known renal
cysts were encountered over an 18-year period. Blunt abdominal trauma and
iatrogenic trauma during retrograde endoscopy accounted for four traumatic
ruptures. In 21 patients, spontaneous communication occurred between the
cyst and the collecting system or the perinephric space. Hematuria was the
most frequent manifestation (21 patients [84%]), followed by flank pain (17
patients [68%]). The diagnosis was made by means of infusion
nephrotomography in 22 patients, computed tomography in two, and retrograde
pyelography in one. Follow-up information was obtained in 21 patients. The
communication of the cyst with the collecting system closed spontaneously
in 11 patients and persisted in two. Six patients were operated on because
of coexisting stones, persistent hematuria, infection, or the uncertain
nature of the cyst, and two underwent cyst evaluation by percutaneous
needle aspiration. Renal cyst rupture is an infrequent, usually
self-limiting event that may sometimes pose diagnostic dilemmas.
