Urinoma

Case contributed by Dr Varun Babu

Presentation

Right ureteric colic

Patient Data

Age: 70 years
Gender: Male

CT abdomen and pelvis

Modality: CT
  • obstructive right VUJ calculus. 
  • dilated right renal pelvicalyceal system as well as entire ureter with  periureteric free fluid. 
  • circumscribed fluid seen in the perirenal space associated with thickening of anterior and posterior pararenal fascia with fluid tracking inferiorly along the iliospoas. 
  • associated fluid along ascending colon and right paracolic gutter. 
  • exophytic right renal cyst. 

Case Discussion

Perinephric fluid collection especially in the perirenal space following long standing obstruction is suggestive of urine extravasation or urinary leak. 

Whilst contrast extravasation into the fluid collection in delayed excretory phases in the form of increasing density of the perinephric fluid confirms urine extravasation, it is not necessary and a fairly confident diagnosis can be made in the non contrast KUB study. 

Depending on the extent of extravasation, fluid may opt to remain confined to the perinephric space, track inferiorly along the iliopsoas, or even medially along renal vessels into the contralateral perirenal space. 

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Case Information

rID: 46814
Case created: 18th Jul 2016
Last edited: 18th Jul 2016
System: Urogenital
Inclusion in quiz mode: Included

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