Intraperitoneal Urine Leak After Prostatectomy Confirmed by 99mTc-MAG3 Renogram

Abstract

A 67-year-old patient presented with abdominal pain and distension 2 days after robotic radical prostatectomy for prostate carcinoma. He became anuric, and his serum creatinine level doubled, making IV contrast contraindicated. Abdominal CT without contrast demonstrated hypodense fluid in the peritoneum. Tc-MAG3 renogram detected extravasation of radiotracer from the bladder. Follow-up retrograde cystogram revealed a posterior anastomotic leak. The patient underwent uneventful surgical repair and made a full recovery. This case demonstrated that Tc-MAG3 can prove leak from the urinary tract, particularly helpful in the setting of poor renal function and contraindication to IV contrast.

Uroperitoneo como causa de ascitis recurrente. Una etiología que no debe ser olvidada

“…Puede deberse a trauma, ruptura espontánea de la vejiga o perforación (10) . Por otro lado, se ha descrito de manera iatrogénica secundaria a procedimientos quirúrgicos como cirugías gastrointestinales (15) , urológicas (16,17) , ginecológicas (18) y obstétricas (19) con una incidencia de 0,11% (20) . Los principales factores de riesgo para lesión iatrogénica de la vejiga que se han identificado son edad avanzada, quimioterapia o radioterapia reciente y tabaquismo (20) .…”

Nuclear medicine and the emergency department patient: an illustrative case-based approach

“…185 MBq of Tc-99m MAG3 is injected intravenously. Flow images are obtained over the first minute, followed by additional dynamic images for 30 min [42,43,52]. A static image is obtained after voiding.…”