Medicine:Urinoma
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A urinoma, also pararenal pseudocyst, is an encapsulated collection of extravasated urine and typically found in the area adjacent to the kidneys[1][2] or to extend into the retroperitoneum.[3]
Diagnosis
A urinoma is the result of a breach of the integrity of the pelvis or calices of the kidney or of the ureter.[4] The urine collection in the perirenal fat causes an inflammatory response with lipolysis resulting in its fibrous encapsulation. Urinomas are usually caused by blunt trauma to the kidneys. While extravasation of urine is common as a result a severe blunt trauma (2-18%), spontaneous resolution is typical, and urinoma formation develops only in few instances.[5] Less common causes of urinoma development are ureteral obstructions due to cancer, calculus formation, pregnancy, or congenital causes.[1][2][3]
Urinomas tend to develop gradually. Symptoms depend on size and location of the lesion.[3] Eventually local pain and pressure symptoms may become apparent. Biochemical testing of renal function is indicated. Imaging (IVP, ultrasonography, CT scan) will identify the lesion. Image-guided percutaneous needle aspiration is both diagnostic and therapeutic.[2]
Management
If left untreated, complications may arise including abscess formation, peritonitis, sepsis, and damage to the urinary tract by fibrosis and granuloma formation. It is recommended, as a first step, to drain the lesion with ultrasound or CT guidance.[1][2] If a patient has an underlying obstructive problem it needs to be addressed according to its cause.[3]
See also
- Extravasation of urine
References
- ↑ 1.0 1.1 1.2 "Percutaneous Drainage of a Late-onset Giant Posttraumatic Urinoma". Urol J 6 (3): 214–6. 2009. PMID 19711278.
- ↑ 2.0 2.1 2.2 2.3 "A case report:Urinoma as initial presenting sign of bladder malignancy". Indian Journal of Cancer 48 (4): 516–7. doi:10.4103/0019-509X.92251. PMID 22293273.
- ↑ 3.0 3.1 3.2 3.3 "Perirenal urinoma formation in a patient with a complex pelvic cyst". BJUI [1].
- ↑ "Percutaneous catheter drainage of post-traumatic urinoma". J Urol 134 (2): 319–21. Aug 1985. doi:10.1016/s0022-5347(17)47147-3. PMID 4020986.
- ↑ "Urinoma following blunt renal trauma.". MJAFI 2000; 56:3446.
External links
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