Do changes in intra-abdominal pressure during air travel increase risk of spontaneous rupture of the renal pelvis?

摘要

Spontaneous rupture of the renal collecting system almost always occurs in previously diseased kidney however spontaneous rupture without identified underlying cause has been reported . Impact of flying on passenger health is well documented but effect of air travel on an obstructed pelvicalyceal system is not reported . We present two cases with spontaneous peripelvic extravasation possibly related to long-haul flights. Case 1 58-year-old male presented after transatlantic flight with severe right loin to groin pain which commenced in-flight. Abdomen was soft with right renal angle tenderness, urinalysis was positive for blood. IVU demonstrated right-sided peripelvic leak with no obvious stone. Plain CT also showed a right perirenal collection with no clear associated pathology. Patient recovered completely with conservative management. Case 2 58-year-old male presented with left loin to groin pain commencing during an 8 h flight. Examination revealed soft abdomen, left renal angle tenderness and blood/protein on urinalysis. Plain KUB showed possible calculus at the left vesico-ureteric junction. IVU showed left peripelvic extravasation with a tiny VUJ calculus. Patient settled with conservative management, KUB at two weeks showed stone passage.