Post traumatic urinoma

Case contributed by Dr Ahmed Abd Rabou

Presentation

The child was involved in motor vehicle accident and received blunt abdominal trauma

Patient Data

Age: 9 years
Gender: Female
CT

Axial portovenous phase images reveal a large large fluid collection in the right anterior perirenal space and the hepatorenal space. Small amount of fludi in the right paracolic gutter and a small right pleural effusion.

Delayed images reveal a connection between this fluid and the upper calyx. The collection filled gradually with contrast, indicating a urine leak. 

The pelvic images show a pre-sacral hematoma and bone window images show a sagittaly oriented right sacral ala fracture with small detached fragment.

Diagnosis: Post traumatic urinoma

Annotated image

Illustrated selected images from the study, with annotations to illustrate key findings.

Case Discussion

An extra-renal urine collection (urinoma) can occur following acute urinary tract obstruction, trauma or iatrogenic after surgery or renal intervention e.g. biopsy.

A urine leak usually collects beneath the renal capsule (sub-capsular) or outside the capsule in the perirenal space.

Contrast study e.g. IVU or C-IVU are the main diagnostic methods.

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Case information

rID: 24644
Case created: 1st Sep 2013
Last edited: 29th Aug 2017
Tags: kidney, trauma
Inclusion in quiz mode: Included

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