Urinothorax after ultrasonography-guided renal biopsy: a case report

Tae Won Lee,Hyun Seop Cho,Se-Ho Chang,Bong-Hoi Choi,Dong Jun Park,See Min Choi,Ha Nee Jang,Eunjin Bae

doi:10.1186/s12882-018-0903-8

Abstract

BackgroundUrinothorax is defined as the presence of urine in the pleural space and is a rather rare cause of transudate pleural effusion. The potential etiologies are urinary tract obstruction and trauma. Diagnosis requires a high index of clinical suspicion and the condition is completely reversible following relief of underlying disease.Case presentationWe report a 27-year-old man who developed urinothorax after renal biopsy. Urine leakage was confirmed with 99mTc DTPA (diethylenetriaminepentacetate) and single-photon emission computed tomography scans and retrograde pyelography. The pleural effusion was completely resolved by removing the leakage with a Foley catheter and a double J stent.ConclusionsUrinothorax has not been reported in patients doing renal biopsy in the literature. Based on our experience, urinothorax should be suspected, diagnosed, and managed appropriately when pleural effusion occurred after renal biopsy.

Highlights

Urinothorax is defined as the presence of urine in the pleural space and is a rather rare cause of transudate pleural effusion
Urinothorax has not been reported in patients doing renal biopsy in the literature
Urinothorax should be suspected, diagnosed, and managed appropriately when pleural effusion occurred after renal biopsy

Summary

Background

Urinothorax refers to the presence of urine in the pleural space, but rarely causes pleural effusion [1]. Biopsy result revealed idiopathic membranous nephropathy and he received conservative management, including a low salt and protein diet, 80 mg of furosemide, and 80 mg of valsartan for 3 months He had been admitted to the department of nephrology due to transudative left pleural effusion, which was considered a complication of nephrotic syndrome and was. Radionuclide scintigraphy and single-photon emission computed tomography (SPECT-CT) using 99mTc DTPA revealed urine leakage from the lower pole of the left kidney to the left sub-diaphragm and the pleural space 5 h after injecting the tracer (Fig. 2). This leakage was confirmed through retrograde pyelography (RGP) (Additional file 1: Fig. S1).

Findings

Discussion

Conclusions