Spontaneous ureteral rupture secondary to distal ureteric stone presenting as perinephric urinoma: A case report of a rare urological emergency

Spontaneous ureteral rupture is a rare complication of obstructive uropathy that may mimic infection and delay diagnosis. We report a 48-year-old man with persistent left flank pain initially treated as pyelonephritis. Imaging showed worsening hydronephrosis and perinephric fluid. Contrast-enhanced CT demonstrated a <3 mm distal ureteric stone at the ureterovesical junction with contrast extravasation, confirming ureteral rupture and urinoma. The patient underwent emergency ureteral stenting followed by delayed ureteroscopy and lithotripsy, with complete recovery. Early CT imaging and prompt decompression are essential for accurate diagnosis and optimal outcomes in such cases.