Urinoma secondary to urinary obstruction with renal vein thrombosis
Diagnosis almost certain
Presentation
Known case of hepatitis B presented with urinary retention and left flank pain. No past history of trauma or previous surgery.
Patient Data
Age: 55 years
Gender: Male
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The CT images demonstrate:
- distended urinary bladder with a thickened wall
- mild-to-moderate bilateral ureterohydronephrosis with no ureteric stone seen.
- prostatic hypertrophy (90 grs in this case).
- retroperitoneal fluid collection is noted in the left perirenal space corresponding to a urinoma confirmed on the excretory phase (contrast extravasation), indicating a rupture of the collecting system.
- left renal vein thrombosis was seen as a filling defect within the renal vein on the portal venous phase with a lack of parenchymal enhancement as compared to the right kidney.
- liver cirrhotic changes are seen as hypertrophy of the caudate lobe, atrophy of the segment IV with irregular borders. Dilated portal vein (16 mm) with no enlarged spleen.
Case Discussion
CT urography of a urinoma due to urinary obstruction (urinary retention on prostatic hypertrophy) with associated renal vein thrombosis which is considered as a rare consequence of obstructive uropathy.
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