Urinoma Secondary to Posterior Urethral Valve Presenting with Features of Intestinal Obstruction in a Neonate: A Case Report SD04-SD06
Dr. Sandeep Lahiry,
244 A.J.C Bose Road, Department of Pharmacology, Institute of Post Graduate Medical Education and Research,
S.S.K.M Hospital, Kolkata-700020, West Bengal, India
Urinoma (or perirenal uriniferous pseudo cyst) occurs due to extravasation of urine in the perirenal space. Common causes include traumatic renal injury or an obstruction in the outflow tract as in a posterior urethral valve. Though rare, such diagnosis should be considered in neonates presenting with expanding cystic masses in the abdomen.
Here, we present a case of a four-day-old neonate, who presented to us with abdominal distension and bilious vomiting. The initial radiographic studies showed a cystic mass surrounding the right kidney. Urine was aspirated from the mass and Micturating Cysto-Urethrogram (MCU) showed the presence of a Posterior Urethral Valve (PUV). A diagnosis of urinoma secondary to PUV was confirmed. After relieving the obstruction by vesicostomy, symptoms of intestinal obstruction resolved. On later follow up, size of urinoma also gradually decreased.
This proves that not every case of a distended abdomen and bilious vomiting in a neonate, necessarily points towards Necrotising Enterocolitis (NEC) or intestinal obstruction.