Raja Ahmad, Dhakal Abhinav, Sinyagovskiy Pavel, Abdalla Mohammed, Afridi Summia Matin
Internal Medicine, Bassett Healthcare Network, Cooperstown, USA.
Medicine, University of Arizona College of Medicine - Tucson, Tucson, USA.
Cureus. 2022 May 27;14(5):e25392. doi: 10.7759/cureus.25392. eCollection 2022 May.
Urinothorax is a rare cause of pleural effusion, which is seen in patients with obstructive uropathy, blunt trauma, or ureteric injury during abdominal surgical procedures. Clinical symptoms may include dyspnea, chest pain, cough, fever, abdominal pain, and decreased urine output. Diagnosis is made by thoracentesis, which would reveal fluid with a urine-like odor, and pleural fluid analysis, which would show if fluid is transudative in nature with a pH lower than 7.30. Pleural fluid to serum creatine ratio of more than 1 is diagnostic for this condition. In our case, the patient underwent percutaneous nephrolithotripsy with a stent placement three days before presentation to the hospital. She was diagnosed with urinothorax, which led to further investigations, and she was found to have persistent hydronephrosis. Her condition improved after her underlying hydronephrosis was addressed with stent placement. She was discharged home in stable condition.
尿胸是胸腔积液的一种罕见病因，见于梗阻性尿路病、钝性创伤或腹部手术过程中输尿管损伤的患者。临床症状可能包括呼吸困难、胸痛、咳嗽、发热、腹痛和尿量减少。通过胸腔穿刺术进行诊断，胸腔穿刺术会抽出有尿样气味的液体，胸膜液分析则会显示液体本质上是否为漏出液，其pH值低于7.30。胸膜液与血清肌酐比值大于1可诊断为此病。在我们的病例中，患者在入院前三天接受了经皮肾镜碎石术并置入了支架。她被诊断为尿胸，这促使进行了进一步检查，结果发现她存在持续性肾积水。在通过置入支架解决了潜在的肾积水问题后，她的病情有所改善。她出院时情况稳定。
