Urinothorax (UT) is a rare and often undiagnosed condition, defined as the presence of urine in the pleural cavity due to the retroperitoneal leakage of urine (known as urinoma) into the pleural space. It is a rare cause of pleural effusion and is secondary to traumatic or obstructive reasons. UT is usually a transudate pleural effusion. Its diagnosis requires a high degree of clinical suspicion, because the respiratory symptoms tend to be absent or mild and urological signs tend to dominate. Thoracocentesis followed by measurement of creatinine in the pleural fluid is a procedure to establish the true diagnosis. The average pleural fluid-to-serum creatinine ratio is in the range of 1.09-19.8. Pleural fluid-to-serum creatinine ratio >1 is the diagnostic criterion of UT. We report a case of UT associated with trauma.
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http://dx.doi.org/10.4103/lungindia.lungindia_95_19 | DOI Listing |
Cureus
July 2024
Internal Medicine, St. Luke's Hospital, Chesterfield, USA.
Urinothorax is a rare complication of urological procedures. This report presents a case of a patient who developed urinothorax following nephrostomy tube placement and percutaneous nephrolithotomy (PCNL). The patient was managed conservatively with chest tube and Foley catheter placement, without the need for surgery.
View Article and Find Full Text PDFJ Med Case Rep
June 2024
Pediatric Intensive Care Unit, Department of Pediatrics, Farwaniya Hospital, Sabah Al Nasser Area, Kuwait.
Objective: Urinothorax and urinoma are rare complications of obstructive uropathy. They might occur due to persistent high back pressure on the renal parenchyma. Urinothorax usually arises while the obstruction exists; in contrast to our case, the child presented after being operated on.
View Article and Find Full Text PDFRespir Med Case Rep
January 2024
Department of Medicine, Division of Pulmonary and Critical Care Medicine, Albany Medical Center 16 New Scotland Avenue, Albany, NY, USA.
Urinothorax is a rare cause of pleural effusion. Infected urinothorax is even rarer. Here we present a case of infected urinothorax from renal mass causing obstructive uropathy.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
June 2024
Division of Thoracic Surgery, Department of Surgery, Cooper University Hospital, Camden, New Jersey.
Urinothorax is a rare form of pleural effusion that can occur after percutaneous instrumentation of the genitourinary tract. We report on the surgical management of a 75-year-old man with a past surgical history of 3-hole esophagectomy who was afflicted with a loculated urinothorax complicated by sepsis after a supracostal percutaneous nephrolithotomy. We demonstrate the efficacy of pleurodesis and decortication in the management of complicated urinothorax that is refractory to medical management.
View Article and Find Full Text PDFUrol Case Rep
November 2023
The Medical University of South Carolina, Department of Emergency Medicine, Charleston, SC, USA.
A 63-year-old female presented with a tension urinothorax after pyeloscopy, lithotripsy, and percutaneous nephrolithotomy that manifested as dyspnea and abdominal pain. CT Thorax demonstrated a large right pleural effusion with middle and lower lobe collapse with leftward shift concerning for tension hydrothorax. Analysis of the effusion after pigtail catheter demonstrated an exudative effusion with resultant resolution of the effusion after a 5-day hospital course.
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