A giant urinoma in a neonate without obstructive uropathy

Area of Science:

• Neonatal Urology
• Pediatric Nephrology
• Medical Imaging

Background:

• Neonatal urinomas are rare collections of urine that can lead to significant complications.
• This case highlights a giant urinoma presenting as a large abdominal mass in a neonate.
• Associated conditions like renal failure and gastroesophageal reflux require prompt diagnosis and management.

Observation:

• A 7-day-old infant developed a 6.5 cm x 8 cm right-sided abdominal mass causing renal failure.
• Radiological imaging showed a multiseptated cyst with no detectable kidneys initially.
• Prenatal ultrasounds had not identified any abdominal cystic lesions.

Findings:

• Percutaneous drainage of the cystic mass yielded urine, confirming it as a urinoma.
• Post-drainage, the infant's symptoms improved, revealing an absent left kidney and a small right kidney.
• Obstructive uropathies and duplex system anomalies were excluded through various imaging and biopsy.

Implications:

• This case underscores the importance of considering giant urinomas in neonates with abdominal masses and renal dysfunction.
• The etiology remains unclear, suggesting potential contributions from delivery trauma or a dysplastic kidney.
• Effective management involves prompt diagnosis and intervention, such as percutaneous drainage, to alleviate pressure and preserve renal function.