Spontaneous forniceal rupture identified by point of care ultrasound

Abstract

Spontaneous forniceal rupture is one of the rarest diagnoses of abrupt onset abdominal pain. Moreover, urolithiasis is the most prevalent cause and coexistent condition. Delayed-phased Contrast-enhanced computed tomography scans or intravenous pyelograms are needed for an exact diagnosis in most circumstances. Herein, we report a case of a healthy middle-aged female who presented to the emergency department with flank and abdominal pain. The diagnosis of forniceal rupture was made by the emergency point of care ultrasound. To the best of our knowledge, this is one of the first cases of spontaneous forniceal rupture secondary to urolithiasis diagnosed by the physician-performed ultrasound before confirmation of the diagnosis with computed tomography. In conclusion, emergency physicians and surgeons should be aware of rare conditions like spontaneous forniceal rupture and its sonographic findings to make a rapid diagnosis of urine extravasation so that unwanted complications are avoided.