Background: Urinoma is an encapsulated collection of extravasated urine, secondary to trauma or obstructive uropathy. Spontaneous bilateral urinoma is rare.

Case Characteristics: 7-year-old boy with cyanotic heart disease and fever of unknown origin.

Obeservation: The ultrasound abdomen and CT abdomen revealed bilateral spontaneous urinoma which was aspirated and was found to be infected. Following intravenous atibiotics the child became afebrile, with subsequent renal scans showing no recurrence.

Message: Hypoxia and consequent polycythemia may be responsible for perinephric leaks leading to Non-traumatic spontaneous urinoma.

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