Blunt Abdominal Trauma Resulting in Urinothorax from a Missed Uretero-Pelvic Junction Avulsion: Case Report

An unusual cause of pleural effusion, urinothorax in a child with urinary stone disease

“…Further invasive studies, such as intravenous injection of radiographic contrast agent, inulin or Tc-99m-DTPA in to the urinoma, can be used to demonstrate the renopleural fistula [1,4,6]. In this case, abdominal USG showing obstructive hydronephrosis, urinoma and elevated urea nitrogen of the pleural fluid confirmed the diagnosis, so we did not need these invasive procedures.…”

“…Urinothorax is known to be a manifestation of retroperitoneal urinary leakage and may be secondary to urinary obstruction, trauma, retroperitoneal inflammation or malignant diseases or after surgical procedures that may cause a fistula between kidney and pleural space [1,2,4,5]. Urinothorax develops in the affected obstructed side [2].…”

“…Urinothorax develops in the affected obstructed side [2]. Urine accumulates in the retroperitoneal space and may occasionally find its way into the pleural space by two mechanisms: either by direct ascending extension with ruptures into the pleural space or, more commonly, via lymphatic connections between the peritoneum and pleural space [2,4].…”

Urinothorax: a systematic review

“…Figure 1 presents a flowchart showing a complete breakdown (2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) of how (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) appropriate studies (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)…”

Urinothorax: a new approach

“…Reported cases include surgical injury [2,8,18,[20][21][22], blunt trauma [23][24][25][26][27][28], attempted percutaneous neprhostomy [2,18,29], attempted kidney biopsy [2], failed neoureterocystotomy [2], acute obstruction secondary to renal calculi with hydronephrosis [14,18,[30][31][32], renal calculi lithotripsy [1,33] and renal transplantation [34,35].…”