Department of Surgery, Inspira Health, Vineland, NJ, USA.
Department of Trauma, Surgical Critical Care and Acute Care Surgery, Crozer-Chester Medical Center, Upland, PA, USA.
Am Surg. 2023 Jun;89(6):2813-2815. doi: 10.1177/00031348211050832. Epub 2021 Nov 14.
Urinothorax, defined as urine within the pleural space, is an uncommon finding in published trauma literature. To date, there are less than ten recorded cases of non-iatrogenic trauma-induced urinothorax, most resulting from blunt traumatic injuries from motor vehicle collisions. Given the rarity of the condition, the diagnosis is often missed or delayed. Once the diagnosis is suspected, the most reliable finding is a pleural fluid to serum creatinine ratio of >1. A confirmed diagnosis of urinothorax then requires drainage of pleural fluid and management of distal ureteral obstruction. Unfortunately, the added complexity of the poly-trauma patient obscures this difficult diagnosis often leading to a delay in treatment and prolonged hospital stay. No current published literature exists on penetrating trauma as a cause of urinothorax. Here, we describe a unique case of urinothorax in a 32-year-old male as a result of penetrating trauma.
尿胸，即尿液出现在胸腔内，在已发表的创伤文献中较为少见。迄今为止，外伤性非医源性尿胸的记录病例不到 10 例，大多数由机动车碰撞引起的钝性创伤所致。由于这种情况很少见，因此诊断常常被遗漏或延迟。一旦怀疑诊断，最可靠的发现是胸腔积液与血清肌酐比值 >1。确诊尿胸后，则需要引流胸腔积液和处理远端输尿管梗阻。不幸的是，多发创伤患者的复杂性掩盖了这种困难的诊断，往往导致治疗延迟和住院时间延长。目前尚无关于穿透性创伤导致尿胸的文献。在这里，我们描述了一名 32 岁男性因穿透性创伤导致尿胸的独特病例。
