The Urinothorax: A Comprehensive Review With Case Series

Austin, Adam; Jogani, Sidharth; Brasher, Paul Bradley; Argula, Rahul; Huggins, John T.; Chopra, Amit

doi:10.1016/j.amjms.2017.03.034

Cited by 24 publications

(42 citation statements)

References 50 publications

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“…True prevalence is unknown as only case reports are available in the literature. The development of urine in the pleural space is due to a mismatch of the rate of pleural fluid accumulation and the rate of reabsorption via pleural lymphatics [ 1 ]. This accumulation occurs by a direct or indirect mechanism.…”

Section: Discussionmentioning

confidence: 99%

“…Toubes et al reported that 64% of patients reporting dyspnea on admission presented with a UT occupying greater than two-thirds the hemithorax [ 2 ]. UT is most commonly ipsilateral to urologic pathology, however there are cases of bilateral or contralateral pleural effusions [ 1 , 2 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Urinothorax [UT], the accumulation of urine in the pleural space, is an uncommon etiology of pleural effusions resulting from trauma, obstruction, or iatrogenic issues [ [1] , [2] , [3] ]. This was first documented in 1968 and requires a high clinical index of suspicion [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…This was first documented in 1968 and requires a high clinical index of suspicion [ 2 ]. Thoracentesis with pleural fluid analysis and evaluation of biochemical characteristics, such as pleural fluid creatinine to serum creatinine ratio, is necessary to establish the diagnosis [ [1] , [2] , [3] , [4] ]. UT is a rare but important diagnosis to keep in mind when evaluating pleural effusions, especially in the setting of trauma or recent urologic procedures.…”

Section: Introductionmentioning

confidence: 99%

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Urine in the lung: An uncommon cause of transudative pleural effusion

Sullivan

Lanham

Bohra

et al. 2020

Respiratory Medicine Case Reports

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Urinothorax [UT], the accumulation of urine in the pleural space, is an uncommon cause of pleural effusions resulting from trauma, obstruction, or iatrogenic causes. Thoracentesis with pleural fluid analysis and evaluation of biochemical characteristics, such as pleural fluid creatinine (PCr) to serum creatinine ratio (Scr), is necessary to establish this diagnosis. This case illustrates a 93 year old man with a complicated past medical history including chronic kidney disease stage 4, adenocarcinoma of the prostate status post brachytherapy complicated by proctitis, high grade transitional cell carcinoma of the right kidney with right hydronephrosis, and recurrent hematuria who was hospitalized for worsening hematuria and suprapubic pain. The patients CXR showed a large right pleural effusion. A repeat thoracentesis was performed removing 1.85L clear yellow fluid. PCr and SCr were 4.1 mg/dl and 3.94 mg/dL respectively. This confirmed the diagnosis of UT with a PCr to SCr ratio of 1.04. Again, diagnosis requires pleural fluid analysis and is associated with a paucicellular, transudative effusion with an ammonia-like odor, acidotic pH less than 7.4, and a PCr to SCr ratio greater than 1.0. Management is dependent on correcting the underlying pathology, such as repairing traumatic GU injury or obstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Urine in the lung: An uncommon cause of transudative pleural effusion

Sullivan

Lanham

Bohra

et al. 2020

Respiratory Medicine Case Reports

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“…Treatment of UT is best accomplished in a multidisciplinary fashion with collaboration between urology, interventional radiology, and pulmonology. [8] The first step in treatment involves drainage of UT for symptomatic relief followed by definitive repair of genitourinary tract pathology. Following definitive repair, symptoms associated with UT typically rapidly improve.…”

Section: Case Presentationmentioning

confidence: 99%

Urinothorax: A rare complication of spontaneous bladder rupture

Edelson

et al. 2019

CRIM

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Urinothorax (UT) is an uncommon cause of pleural effusion where urine collects in the pleural cavity that is usually caused by trauma or urinary obstruction. Spontaneous bladder rupture is another rare condition that is commonly caused by underlying bladder wall pathology and exacerbated by binge alcohol consumption, malignancy, autoimmune disorders, radiation, and obstructive or neurogenic pathology. We present a case of urinothorax caused by spontaneous bladder rupture in an adult patient successfully recognized and treated.

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Pleural Disease

Cárdenas-García¹,

Maldonado²

2020

Evidence-Based Critical Care

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The Urinothorax: A Comprehensive Review With Case Series

Cited by 24 publications

References 50 publications

Urine in the lung: An uncommon cause of transudative pleural effusion

Urine in the lung: An uncommon cause of transudative pleural effusion

Urinothorax: A rare complication of spontaneous bladder rupture

Pleural Disease

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