The Urinothorax: A Comprehensive Review With Case Series.
Am J Med Sci
; 354(1): 44-53, 2017 07.
Article
em En
| MEDLINE
| ID: mdl-28755732
ABSTRACT
Urinothorax is an uncommon thoracic complication of genitourinary (GU) tract disease, which is most frequently caused by obstructive uropathy, but may also occur as a result of iatrogenic or traumatic GU injury. It is underrecognized because of a perceived notion as to the rarity of the diagnosis and the absence of established diagnostic criteria. Urinothorax is typically described as a paucicellular, transudative pleural effusion with a pleural fluid/serum creatinine ratio >1.0. It is the only transudate associated with pleural fluid acidosis (pH < 7.40). When the pleural fluid analysis demonstrates features of a transudate, pH <7.40 and a pleural fluid/serum creatinine ratio >1.0, a confident clinical diagnosis of urinothorax can be established. A technetium 99m renal scan can be considered a confirmatory test in patients who lack the typical pleural fluid analysis features or fail to demonstrate evidence of obstructive uropathy that can be identified via conventional radiographic modalities. Management of a urinothorax requires a multidisciplinary approach with an emphasis on the correction of the underlying GU tract pathology, and once corrected, this often leads to a rapid resolution of the pleural effusion.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Derrame Pleural
/
Urinoma
/
Hidronefrose
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article