@ghaneh_f: Answer to the case: this patient has a urinary leak from forniceal rupture with pyelolymphatic backflow. Instead of collecting only in the collecting system or forming a urinoma, some of the extravasated contrast is absorbed into the renal lymphatics. The clue is the branching, linear pattern of contrast extending toward the renal cortex and along the hilar lymphatic channels rather than simply pooling in the surrounding tissues. It's a subtle but classic imaging finding that's easy to miss if you're not looking closely. Have you seen pyelolymphatic backflow before? Let me know in the comments. #radiology #foamrad #radres #urology #trauma

Ghaneh Fananapazir, MD

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Thursday 06 August 2026 13:36:37 GMT