BACKGROUND A 66-year-old lady was referred to urology for a suspected urinoma after retroperioneoscopy done for debridement of a retroperitoneal abscess that developed following a duodenal perforation.CASE SUMMARY Ser...BACKGROUND A 66-year-old lady was referred to urology for a suspected urinoma after retroperioneoscopy done for debridement of a retroperitoneal abscess that developed following a duodenal perforation.CASE SUMMARY Serous contents of the drain sent for fluid creatinine were elevated confirming this and computed tomography urography findings suggested an upper tract injury with urinoma around the kidney.However,the antegrade nephrostogram suggested otherwise and on flexible cystoscopy and cystogram,an extraperitoneal bladder perforation was instead identified,with tip of retroperitoneal drain sitting inside the bladder.CONCLUSION This case identifies a limitation in the usual diagnostic approach for such injuries and emphasizes the need to exercise caution when managing them especially when they occur after several surgical procedures and in the presence of multiple surgical drains.展开更多
文摘BACKGROUND A 66-year-old lady was referred to urology for a suspected urinoma after retroperioneoscopy done for debridement of a retroperitoneal abscess that developed following a duodenal perforation.CASE SUMMARY Serous contents of the drain sent for fluid creatinine were elevated confirming this and computed tomography urography findings suggested an upper tract injury with urinoma around the kidney.However,the antegrade nephrostogram suggested otherwise and on flexible cystoscopy and cystogram,an extraperitoneal bladder perforation was instead identified,with tip of retroperitoneal drain sitting inside the bladder.CONCLUSION This case identifies a limitation in the usual diagnostic approach for such injuries and emphasizes the need to exercise caution when managing them especially when they occur after several surgical procedures and in the presence of multiple surgical drains.