Lipiduria presenting following right hemicolectomy: A case presentation and brief review of the literature

Abstract

Lipiduria, also known as lipuria, refers to the presence of lipids within the urine. When lipids are present in macroscopic quantities, lipiduria can be visualized as a fat-fluid level on computed tomography imaging. Although the general differential diagnosis of lipiduria is broad, reported etiologies of lipiduria diagnosed by computed tomography have primarily included chyluria, urine-induced lipolysis, and trauma. We report a case of lipiduria occurring coincidentally with resolution of perivesical fat necrosis in a patient after partial right hemicolectomy for B cell lymphoma.

The combined uro-radiological “Rendezvous” procedure, and an unusual CT and cystoscopic finding

“…7 It is a recognised sequelae of fat embolus, 8 and has also been described following partial nephrectomy, renal transplant, and radiofrequency ablation of renal tumours. 9 Whilst microscopic lipiduria may go unrecognised and therefore underreported, macroscopic lipiduria presenting as vesicular fat-fluid level at CT or, as in our patient, as visible fat within the bladder at cystoscopy, is more unusual. A number of cases have been reported, with differing aetiological hypotheses.…”

CT features of feline lipiduria and renal cortical lipid deposition

“…In humans, lipiduria has been identified on CT within the non-dependent portion of the urinary bladder as a fat-fluid level, typically having density values between −180 HU and −20 HU. 27 , 29 Differential diagnoses for this finding include chyluria, trauma and urine-induced lipolysis. 29 Our findings are similar to those described in humans.…”

“…The UFS was defined as an area within the urinary bladder lumen with a mean density between −180 HU and −20 HU, based on published human lipiduria studies. 27 , 29 In cases with UFS, the urinary lipid volume was determined by measurement of the cross-sectional areas of all affected slices with the closed polygon ROI and use of a volume calculation tool. Two groups were subsequently defined based on the presence or absence of UFS and were considered to be positive or negative for lipiduria, respectively.…”

“…Lipid retention in the urinary bladder in humans has been described on CT as an area in the non-dependent urinary bladder lumen. 26 – 30 CT detection of feline lipiduria has not been described.…”

Chyluria in non-filarial endemic areas: an internist’s perspective

“…The causes include that of granulomatous infection,7 pregnancy,8 9 massive mesenteric adenitis,10 glomerular disease,11–13 aortic aneurysm,14 15 neoplasms16–20 and malformations of the lymphatic system 21–27. It has also been reported to occur following trauma28 or surgical procedures like partial nephrectomy,29 30 hemicolectomy,31 cardiac catheterisation,32 oesophagectomy,33 posterior spinal fusion34 and radiofrequency ablation of renal cell carcinoma 35 36. No apparent causes are found in some cases 37 38…”