Garcia-Pachon Eduardo, Romero Santiago
Section of Pneumology, Hospital General Universitario, Elche, Spain.
Curr Opin Pulm Med. 2006 Jul;12(4):259-63. doi: 10.1097/01.mcp.0000230628.65515.86.
The presence of urine in the pleural space (urinothorax) is a rarely recognized cause of pleural effusion. To date, only 58 cases have been reported. In this article the features of urinothorax are analyzed, and clinical and biochemical characteristics are reviewed in order to propose a classification, founded on pathogenic criteria, that will be useful in achieving the diagnosis.
Recently reported cases of urinothorax provide a more detailed description of the biochemical characteristics that allow a better understanding of this entity.
Urinothorax can be divided into two categories: (1) obstructive urinothorax, due to bilateral obstructive uropathy; and (2) traumatic urinothorax, due to unilateral traumatic injury of the urinary system, mostly iatrogenic. In patients with urinothorax, the pleural effusion usually has the biochemical characteristics of a transudate, with a pH lower than 7.30 and a pleural fluid/serum creatinine ratio higher than 1. These characteristics are not always present, however, and individually are shared by a significant number of pleural effusions of different etiology.
胸腔内存在尿液（尿胸）是一种很少被认识到的胸腔积液病因。迄今为止，仅报道了58例。本文分析了尿胸的特征，并回顾了其临床和生化特征，以便提出一种基于致病标准的分类方法，这将有助于实现诊断。
最近报道的尿胸病例对生化特征提供了更详细的描述，有助于更好地理解这一实体。
尿胸可分为两类：（1）梗阻性尿胸，由双侧梗阻性尿路病引起；（2）创伤性尿胸，由泌尿系统单侧创伤性损伤引起，大多为医源性。尿胸患者的胸腔积液通常具有漏出液的生化特征，pH低于7.30，胸水/血清肌酐比值高于1。然而，这些特征并非总是存在，而且许多不同病因的胸腔积液也具有这些特征。
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