Spontaneous urinoma: an unexpected cause of acute abdomen

Pyrpasopoulou, Athina; Georgopoulou, Vivian; Anyfanti, Panagiota; Soufleris, Konstantinos; Koumaras, Haralampos; Chatzimichailidou, S.; Simoulidou, Elisavet; Triantafyllidis, Argyrios; Petidis, Konstantinos

doi:10.1016/j.ajem.2010.05.025

Cited by 4 publications

(3 citation statements)

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“…outlet obstruction (7). Table 1 summarizes all the causes of spontaneous urinoma obtained from literature review.…”

Section: A B D E Cmentioning

confidence: 99%

“…Small urinomas may resorb spontaneously and, therefore, conservative management can be chosen. Nevertheless, large urinomas-even without systemic signs-usually need intervention, either in the form of percutaneous drainage (a drainage catheter can be placed with ultrasound or CT guidance), ureteral stenting (endourological treatment), or open surgery (as exemplified by the case 1) (7). Fluid culture is recommended to guide antibiotic treatment (14).…”

Section: A B Cmentioning

confidence: 99%

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Spontaneous urinoma debuting as retroperitoneal abscess: report of 2 cases and literature review

Medina¹,

García²,

Ruiz³

et al. 2021

Transl Androl Urol

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Spontaneous urinoma is a urological entity that can be complicated by a retroperitoneal abscess.Urinoma can be iatrogenic, traumatic, or can be caused by obstructive uropathy. We report two cases of spontaneous urinomas, describing a not previously published cause of urinoma: pyeloureteritis. (I) A 55-yearold Caucasian female started with intense left-sided flank pain for 3 days. CT scan revealed a voluminous retroperitoneal abscess, which extended through the posterior pararenal space and the left lumbar paravertebral musculature. (II) A 48-year-old Caucasian male presented with constitutional symptoms over the previous 2 months and investigations showed a voluminous urinoma and marked pyeloureteritis findings on CT scan. Both patients were managed by endoscopic placement of a double-J stent and drainage of the collection (open and percutaneous approach, respectively). Urinoma was confirmed by fluid biochemical analysis, which demonstrated that fluid creatinine was markedly raised as compared to the serum creatinine.Urinoma in the absence of obstruction or trauma is rare. These two case reports highlight one of the conditions leading to urinoma and the management of retroperitoneal abscess. Pyeloureteritis is a cause of spontaneous urinoma and it should be considered in the lack of another obstructive cause.

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“…outlet obstruction (7). Table 1 summarizes all the causes of spontaneous urinoma obtained from literature review.…”

Section: A B D E Cmentioning

confidence: 99%

Section: A B Cmentioning

confidence: 99%

Spontaneous urinoma debuting as retroperitoneal abscess: report of 2 cases and literature review

Medina¹,

García²,

Ruiz³

et al. 2021

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…It occurs most commonly secondary to trauma to the urinary tract or obstructive uropathy [2]. Prompt diagnosis and correction of the underlying cause is essential in order to prevent complications such as abscess formation and sepsis.…”

Section: Introductionmentioning

confidence: 99%

Urinoma presenting as an abscess in an immunocompromised host: a case report

Vaidya

Swetz

2013

J Med Case Reports

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IntroductionThis case report illustrates the relatively rare occurrence of a urinoma masquerading as an abscess in a patient with refractory recurrent non-Hodgkin’s lymphoma. Although urinomas have been reported after urinary instrumentation, our case was confounded by a concurrent pleural effusion, an immunocompromised host, and clinical appearance and subsequent incision and drainage that was consistent with an abscess. Although not the first case reported in the literature, the constellation of findings in our patient demonstrates the importance of including urinoma in the differential diagnosis of patients with flank mass.Case presentationHere we report a case of a retroperitoneal fluid collection found in an immunocompromised 65-year-old Caucasian woman. She had recurrent non-Hodgkin’s lymphoma and was neutropenic when the collection was found. Drainage of the fluid demonstrated infection, but the case was complicated by increasing fluid production and the development of an ipsilateral pleural effusion. Despite pleural drainage, the abscess output continued to be high. A computed tomography scan demonstrated fluid collection around the renal calices suggestive of rupture; analysis of the fluid was suggestive of a urinoma. The etiology, pathogenesis, and treatment of urinomas in such patients are discussed.ConclusionsUrinomas can present in patients who have had urinary tract instrumentation or trauma, but can occur in other hosts. Patients with hematologic malignancy can develop malignant or sympathetic pleural effusions and are at risk for skin and soft tissue infections. Clinicians caring for immunocompromised patients, particularly hematologists, oncologists, and transplant clinicians, should be aware of this potential complication because rapid identification and attempt at correction are important to optimize outcome.

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