The patient became apyrexial two days after biantibiotic therapy Urinothorax resolved after pleural drainage and relief of the urinary tract obstruction (Figure 4).
Urinothorax is an uncommon thoracic complication of the urinary tract; it corresponds to accumulation of urine in the pleural cavity which in particular occurs secondary to urinary trauma, obstructive uropathy, and abdominal surgery [1].
A new large right-sided pleural effusion was observed, ultimately confirmed to be a urinothorax secondary to bladder dome rupture at site of prior surgery.
Thoracentesis yielded over two liters of transudative fluid notable for elevated creatinine, greater than concurrent serum levels, raising concern for a urinothorax.
The following case examines the first known reported case of
urinothorax as a complication of XGP.
Urinothorax: pleural fluid looks and smells like urine, transudative, confirmed when pleural fluid creatinine is greater than serum creatinine.
An unusual cause of pleural effusion,
urinothorax in a child with urinary stone disease.
Causes of a transudate Frequent * Congestive cardiac failure * Hypoalbuminaemia * Peritoneal dialysis * Liver failure Infrequent * Hypothyroidism * Nephrotic syndrome * Pulmonary embolism *
Urinothorax * Pericardial constriction * Mitral valve stenosis Table 2.
The following is a case of
urinothorax which required urgent evaluation and management in the face of increasing respiratory insufficiency.
However,
urinothorax, or the collection of urine in the pleural cavity, can occur in rare cases.
Causes of bilateral/variable, left-sided and right-sided pleural effusion Bilateral / Variable Left (*) Right (*) Transudate Left sided heart Constrictive Cirrhotic liver disease failure pericarditis Right sided heart Hypoalbuminemia failure Peritoneal dialysis Meigs' syndrome Nephrotic syndrome Superior vena cava Pulmonary embolism obstruction Hypothyroidism Ovarian hyperstimulation Chylothorax
Urinothorax Exudate Parapneumonic Following Hepatic abscess effusion cardiac Chylothorax Malignant neoplasm surgery Pulmonary embolism Splenic Rheumatoid abscess arthritis Benign Post-MI effusion secondary syndrome to asbestosis Acute Other autoimmune pancreatitis diseases Pancreati- Subphrenic abscess copleural Uremia fistula Drug induced Radiotherapy Esophageal rupture Table 5.