The following is a case of urinothorax which required urgent evaluation and management in the face of increasing respiratory insufficiency.
6) Our patient's urinothorax was secondary to tract formation from nephrostomy tube placement as evidenced on CT.
Increasingly complex urologic procedures may lead to an increased frequency of urinothorax.
Key Words: urinothorax, nephropleural fistula, pleural effusions, percutaneous nephrostomy
Urinothorax, the presence of urine within the pleural cavity, is a very rare cause of transudative pleural effusions.
The key criteria for the diagnosis of urinothorax, a pleural to serum creatinine ratio of >0.
While most cases of urinothorax are due to obstruction, secondary to tumor/metastasis, or trauma of the ureter, there have been other reported causes.
Diagnosis of urinothorax is similar to any pleural effusion.
Urinothorax should be suspected if the sample is straw colored or has a urine-like odor.
Urinothorax should be included in the differential in patients with hydronephrosis, (14) renal pathology or recent placement of a percutaneous nephrostomy tube.