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Case of urinothorax - A rare presentation
Aditya Kumar Chawla1, Gaurav Chaudhary1, Madhav Kumar Chawla1
1Department of Respiratory Department, Jaipur Golden Hospital, Rohini Delhi, India.
Lung India : Official Organ of Indian Chest Society
|January 4, 2020
Summary
Urinothorax, urine in the pleural space, is a rare condition often missed. Diagnosis relies on a pleural fluid-to-serum creatinine ratio greater than 1, confirmed via thoracentesis.
Area of Science:
- Nephrology
- Pulmonology
- Urology
Background:
- Urinothorax (UT) is a rare condition characterized by urine accumulation in the pleural cavity.
- It results from retroperitoneal urine leakage (urinoma) into the pleural space, often secondary to trauma or obstruction.
- UT typically presents as a transudate pleural effusion.
Observation:
- Diagnosis of UT requires high clinical suspicion due to often mild or absent respiratory symptoms, with urological signs being more prominent.
- Thoracentesis with pleural fluid creatinine measurement is crucial for diagnosis.
- A pleural fluid-to-serum creatinine ratio exceeding 1 is the diagnostic hallmark.
Findings:
- The study reports a case of Urinothorax associated with trauma.
- The pleural fluid-to-serum creatinine ratio in UT cases typically ranges from 1.09 to 19.8.
- A ratio >1 confirms the presence of urine in the pleural space.
Implications:
- This case highlights the importance of considering Urinothorax in patients with unexplained pleural effusions, especially after trauma.
- Accurate and timely diagnosis through creatinine ratio measurement can prevent delayed treatment.
- Understanding the diagnostic criteria for UT is vital for clinicians managing pleural effusions.
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