Intraoperative ureteral trauma: a radiologic approach.

Thirty-two patients with inadvertent intraoperative ureteral trauma or ligation are presented. One-third of the injuries were due to general surgical procedures such as lumbar sympathectomy, aortoiliac bypass and colectomy. Because of postoperative pain, discomfort and sedation, these injuries are frequently unrecognized for long periods. This delay in diagnosis results in significant morbidity and mortality. The usual radiologic approach is an excretory urogram supplemented if necessary by a retrograde pyelogram. Temporary percutaneous or operative nephropyelostomies have been employed in seven of these patients.