Case Report: Spontaneous dissection of the renal pelvis and ureter

Spontaneous dissection of the renal pelvis and ureter is a rare urinary system disease characterized by separation between the muscularis and mucosal layers or within the muscularis of the pyeloureteral wall, with urine extravasation into the false lumen causing renal colic and hydronephrosis. We report a 30-year-old woman with no prior kidney stone history who presented with paroxysmal colic, nausea, and a 1-month history of abdominal pain that had exacerbated over 1 day; urinalysis showed multiple abnormalities. Non-contrast computed tomography (CT) revealed pyeloureteral dilation without calculi. Further computed tomography urography (CTU) demonstrated a double-lumen sign in the right renal pelvis and upper ureter, with significantly lower CT values on the dissected side suggesting urinary obstruction. The patient underwent ureteral stenting with prompt symptom relief. This case highlights that CTU reliably diagnoses spontaneous dissection of the renal pelvis and ureter, and early interventional treatment resulted in symptom relief and short-term favorable outcome in this patient, providing a valuable clinical reference for managing this rare disease.