Test Yourself

Case 1

HISTORY

Right loin pain, similar to previous renal colic but worse

ULTRASOUND FINDINGS

At the lower pole of the right kidney there is a perinephric fluid collection. This has decompressed into the peritoneal space and a fluid tract passing through the retroperitoneum and the breach of  the posterior peritoneum is evident.

DISCUSSION

The likely mechanism is a breach of the collecting system due to increased pressure caused by ureteric obstruction. This has allowed the hydronephrosis to resolve but has resulted in this perinephric collection and breach into the peritoneal space - an auto-nephrostomy!

SUBMITTED BY:

James Rippey


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Longitudinal view lower pole right kidney

Urinoma breaching the peritoneum
Longitudinal view lower pole right kidney Longitudinal view lower pole right kidney