Perinephric Urinoma Secondary to Perforated UPJ Obstruction Diagnosed Using Tc-99m Mercaptoacetyltriglycine (MAG3) SPECT/CT

Abstract

Abstract: An 80-year-old woman presented with a history of right flank pain and tenderness. Her white cell count and C-reactive protein were elevated at 12.3 × 109/L and 108 mg/L respectively. An ultrasound scan of the abdomen showed moderate right sided hydronephrosis without ureteric dilatation and a collection at the lower pole of the kidney. An isotope renogram was performed using Tc-99m mercaptoacetyltriglycine (MAG3) to assess the presence of renal obstruction and to look for evidence of a urinary leak. Planar images revealed partial obstruction of the right kidney and unusual accumulation of tracer inferior to the kidney. SPECT/CT was performed to further evaluate the location of the abnormal tracer accumulation. Fused images demonstrated a posterior perirenal urinoma due to rupture of the collecting system. The patient underwent retrograde ureteric stenting and made an uneventful recovery.