Urinoma after renal tumour enucleation

Case contributed by Dr Dominik Maas

Presentation

7 days post tumor enucleation of the right kidney, the patient experienced decreasing renal function, rising inflammation parameters, and a swollen area at the operative site as well as scrotal and penile oedema.

Patient Data

Age: 50 Y
Gender: Male
Modality: CT

Perirenal fluid and a displaced right nephroureteral catheter. Parenchymal defect after tumor enucleation.

Free air in the perirenal space.

Comprered with the other side, there is less enhancement of the right kidney.

Urogram - 20 minutes

Modality: CT

20 min delayed phase. No extravasation into the perirenal space can be detected.

Urogram - 90 minutes

Modality: CT

90 min delayed phase. Urinoma of the right kidney through a parenchymal defect after tumor enucleation.

Modality: Fluoroscopy

Right nephroureteral catheter. Dislocation into the pyeloureteral junction. Retrograde contrast and replacement of the catheter. A small laterodorsal extravasation can be observed.

Case Discussion

7 days after tumor enucleation of the right kidney, the patient experienced decreasing renal function, rising inflammatory parameters.

A multiphase CT scan was performed. After a 20 min delayed phase, it was not clear if the fluid in the right pararenal space was a urinoma. Only after 90 min, increased attenuation of the perirenal fluid (and extravasation) can be detected.

The dislocated nephroureteral catheter may have led to increased pressure in the upper collecting system, contributing to the formation of the urinoma.

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Case Information

rID: 35533
Case created: 9th Apr 2015
Last edited: 27th Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

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