Spontaneous Rupture of Renal Pelvis Secondary to Extrinsic Compression of Sigmoid Volvulus

Blood investigations showed a Hemoglobin of 137 g/L (Normal 110 g/L-165 g/L), raised white cell count of 17.6 × 109/L (reference 4.5 × 109/L 11 × 109/L), normal platelets and C reactive protein (CRP) of 70 mg/L (Normal < 10 mg/L). Her electrolytes, liver and renal functions were essentially normal. The eGFR at the time of presentation was 82 (reference range > 90). Urine dip stick examination was essentially within normal limits. Her chest X-ray did not identify any evidence of pneumoperitoneum while abdominal X-ray showed a classic coffee bean sign suggestive of a volvulus (Figure 1). A Computerized Tomography scan (CT scan) of Abdomen and Pelvis confirmed the features of volvulus and no other bowel related pathology was identified. No other intra-abdominal catastrophes noted on the initial CT scan. Introduction