A 63-year-old woman with a history of nephrolithiasis and long-term hemodialysis (HD) presented with abdominal pain. Abdominal computed tomography (CT) showed urinoma induced by renal forniceal rupture, and three causative calculi. No active stone growth or new stones were observed when compared with previous CT, however, fragmentation and migration of an existing stone was observed. After ureteroscopic lithotripsy and stenting with a double-J catheter, the patient made a full recovery. To the best of our knowledge, this is the first case of spontaneous renal forniceal rupture in an anuric HD patient caused by calculi. Renal forniceal rupture can occur, even in anuric HD patients.

Acute pulmonary embolism (PE) is a common and often catastrophic disease. Early diagnosis and treatment of PE is im-portant, however, prompt diagnosis is difficult due to nonspecific clinical manifestations. On the other hand, syncope may develop as a presenting symptom of PE, and defecation activity could trigger PE. In Korea, PE associated with defecation has not been previously reported. We report on a case of acute massive PE presenting as defecation syncope in a 26-year-old female with a serous borderline tumor of the ovary.