A fornix rupture is a tear in the pelvis of the kidney. The term is derived from the Latin for “rupture.” The damage, which is typical of the disease, occurs at the renal pelvis at that section that transitions to the parenchyma. Thus, the rupture is located close to the parenchymal tissue. As a result of the fornix rupture, urine leaks from the pelvis of the kidney into the surrounding tissue. In numerous cases, the cause of the condition is found in acutely increased pressure acting on the caliceal system of the renal pelvis.
What is a fornix rupture?
Basically, fornix rupture is damage to the renal pelvis in a specific section where the parenchyma attaches. The rupture in the renal pelvis forms due to a sudden increase in pressure acting on the corresponding area. Such an increase in pressure results in some cases, for example, from stones in the ureter. As a result, a rupture may occur in the renal pelvis. People who have to wear an excretory aid and at the same time suffer from colic are also particularly at risk. This is because the draining effect of contrast substances significantly increases the pressure in the renal pelvis in a state of colic. Consequently, the risk of fornix rupture increases significantly. Urine enters the surrounding tissues through the tear in the renal pelvis.
Causes
In principle, a fornix rupture represents an acute urologic emergency. The causes of disease development are sometimes different in affected patients. Some triggers are more common than others. For example, ureteral stones are often responsible for the development of fornix rupture. This is because the stones cause the pressure in the renal pelvis to increase. An increase in pressure in the renal pelvis makes the occurrence of complications such as fornix rupture more likely. Often, affected patients wear an elimination program. For this reason, such aids to elimination are only suitable for patients who are not suffering from pain. Individuals with colic also have a significantly increased risk of developing a fornix rupture. Artificially induced diuresis is particularly dangerous. In the majority of cases, however, stones in the ureter are responsible for fornix rupture. In some patients with fornix rupture, only one cause causes the rupture to occur in the pelvis of the kidney. In other groups of patients, however, a combination of causative factors occurs, eventually leading to fornix rupture.
Symptoms, complaints, and signs
In the context of fornix rupture, various symptoms of the disease are manifested, which in most cases are comparatively clear indications of the disease at hand. In principle, it is a typical combination of complaints caused by a fornix rupture. Initially, the renal pelvis ruptures close to the parenchyma. In the initial stage, the signs of the disease are still relatively minor. Fornix rupture often does not immediately cause clearly noticeable symptoms. Gradually, however, symptoms such as fever and pain in the area of the kidney and abdomen develop. In addition, various complications are possible in the course of a fornix rupture, such as abscesses and peritonitis. In a proportion of patients, symptoms such as sepsis and ileus also develop.
Diagnosis
If patients suffer from typical symptoms and signs of illness of a fornix rupture, medical advice should be sought as soon as possible. Because this is an acute emergency, hesitation and waiting for improvement are not appropriate. This is because the potential complications of fornix rupture are sometimes risky and life-threatening, for example, if sepsis develops. First, the physician clarifies the individual symptoms of the disease and possible factors that contributed to the development of the symptoms as part of the medical history. Then, various clinical examination procedures are used to clearly diagnose the fornix rupture. For example, the physician performs ultrasound examinations to visualize the area of the kidney. In addition, histological examinations may be used. Analyses of the blood are also important, with decisive values being tested. Prompt diagnosis of fornix rupture is essential in order to quickly initiate effective treatment of the condition and minimize the risk of subsequent complications.
Complications
In most cases, fornix rupture results in severe pain in the area of the kidneys and abdomen. This pain is accompanied by fever and headache. Likewise, the affected person may develop abscesses. Treatment must be given immediately by a doctor so that the kidneys do not suffer too much damage. If sepsis develops due to the rupture of the kidney, this can lead to a life-threatening condition for the patient. Detection of the disease is usually uncomplicated by ultrasound examination, so there are no complications in the process. In most cases, treatment is by surgical intervention and leads to success. Complications can occur if the patient does not seek immediate medical attention for a fornix rupture. Similarly, inflammation or infection can occur after surgery, so the affected person usually has to take antibiotics to prevent it. Due to the fornix rupture, the patient’s daily life is extremely limited, as the pain in the kidney is almost unbearable. Immediate treatment is necessary.
When should you go to the doctor?
A visit to the doctor is necessary as soon as pain and discomfort during locomotion are noticed. If these occur suddenly and are not due to overexertion, they should be examined and treated by a doctor. Consultation with a physician is necessary before taking pain-relieving medication. There is a risk of further impairment, which should be avoided. If there are problems with usual movements or in the resting position, this is considered unusual. A visit to the doctor is necessary to determine the cause and initiate treatment. A visit to the doctor is necessary if the body is in an incorrect position or if there is a persistent one-sided strain. There is a risk of permanent damage to the skeletal system without correction. If muscle discomfort, twitching or trembling of the limbs occurs, a doctor must be consulted. In case of fever, dysfunctions of the kidney activity or complications in the abdomen, it is advisable to consult a doctor. Abnormalities in urination or decreased fluid intake are worrisome and must be clarified. An inner restlessness, a general feeling of malaise or a general weakness should be discussed with a doctor as soon as they persist unabated over a longer period of time. If the usual level of performance drops, behavioral abnormalities appear or everyday life can no longer be managed without symptoms, it is necessary to establish contact with a doctor.
Treatment and therapy
A fornix rupture can be treated with different approaches and options. The ways of treatment depend, among other things, on the respective underlying causes that have led to the fornix rupture. Often an obstruction in the outflow of urine causes a strong increase in pressure in the renal pelvis, for example in the presence of urinary stones. In such cases, it is necessary that a splint is placed in the ureter so that the urine can drain. In addition, prophylaxis of infectious diseases is necessary. In most cases, antibiotic agents are used for this purpose. In this way, certain complications and secondary difficulties can be avoided to a certain extent. Basically, in the therapy of fornix rupture, it is essential to establish and maintain a healthy pressure system of the kidney.
Outlook and prognosis
People who suffer a fornix rupture are, in most cases, already receiving medical treatment for another condition. Therefore, it is not possible to make a general statement about prognosis. Since fornix rupture is an acute emergency, life-threatening conditions develop if the fastest possible care as well as intensive medical care are not provided. In addition to inflammation, severe pain or kidney damage, sepsis may develop. A complete recovery is normally not given despite all efforts. Relief of symptoms occurs, but lifelong consequences are to be expected. The rupture can be treated well, but impairments of mobility or restrictions of lifestyle remain. There are often changes in the digestive tract as well as a change in daily habits and food intake. To achieve rapid relief of symptoms, surgery is performed in the emergency.Every surgical intervention is associated with risks and possible complications. If the operation is successful, the doctors immediately turn their attention to the causal disease. Health improves after a few weeks, when wound healing is complete and treatment of the underlying disease is successful. The renal pelvis must be relieved so that the increase in pressure in this area decreases. Due to the fornix rupture, there is a decreased physical capacity.
Prevention
In some cases, prevention of fornix rupture is possible by taking special care from the medical side to monitor risk factors in patients at risk. For example, close monitoring is necessary in elimination programs.
Follow-up
The sufferer of a fornix rupture usually depends first on proper and complete treatment of the condition. Special measures of aftercare are usually not available to the patient and are thereby mostly also not necessary. The earlier the disease is detected, the better is usually the further course. A self-healing of the fornix rupture cannot occur, so that a treatment by a physician is indispensable. The treatment itself is usually carried out with the help of medication, but depends very much on the underlying disease of the fornix rupture. Often, sufferers are dependent on taking antibiotics to completely alleviate the symptoms. When taking them, care should be taken not to take them with alcohol, as this will weaken their effect. They should be taken as long as prescribed by the doctor, even if the symptoms have already subsided. It is not uncommon that care and support from friends and acquaintances have a positive effect on the course of the disease. The life expectancy of the patient usually remains unchanged by this disease.
What you can do yourself
In the case of a fornix rupture, affected persons can take some measures themselves to promote the healing process and avoid complications. First and foremost, it is important to see a doctor, because even if the rupture heals itself in some cases, drug therapy must always be given. Early use of antibiotics prevents infections in the urethral area and thus secondary difficulties. Accompanying this, the causes of the rupture must be determined and remedied. For example, if the symptoms are due to a urinary stone, a change in diet is indicated. Sports activities, especially jogging or jumping rope, can help to expel the foreign body naturally. In some cases, however, surgical measures must be taken. After surgery, the diet prescribed by the doctor should be followed, as the affected area in the urethra is usually still sensitive. It is also advisable to have regular check-ups. Patients suffering from a pre-existing kidney disease should discuss a change in medication with the doctor in charge. In addition, preventive measures should be taken to avoid recurrence of urinary stones and subsequent fornix rupture.
