Gurtner B
Medizinische Klinik, Spital Wetzikon.
Schweiz Rundsch Med Prax. 1994 Jan 11;83(2):30-5.
Considering the only 38 cases which have been published one may believe that the accumulation of urine in the thorax would be a very uncommon cause of pleural effusion. But the lack of reported observations could also reflect a lack of suspicion. A leakage of the urinary tract following obstruction of various origins and/or a local trauma is known as urinoma. Due to excess pressure, this retroperitoneal or intraperitoneal collection of urine gives way to a transdiaphragmatic evasion. Therefore, a concomitant ipsilateral or bilateral pleural effusion should be suspicious of urinothorax. Thoracocentesis, followed by measurement of creatinine in the pleural fluid, is a simple procedure to establish the true diagnosis. This is a report of two patients with urinothorax, resulting from uterine and prostatic adenocarcinoma. In the first case, urine passed through a leakage of the bladder into the peritoneal cavity; in the second case, there was hydronephrosis with pelvic disruption.
考虑到仅发表了38例病例,人们可能会认为胸腔内尿液积聚是胸腔积液非常罕见的原因。但缺乏报告的观察结果也可能反映出缺乏怀疑。各种原因引起的梗阻和/或局部创伤后尿路渗漏称为尿瘤。由于压力过大,这种腹膜后或腹腔内尿液积聚可导致经膈肌逸出。因此,伴有同侧或双侧胸腔积液应怀疑为尿胸。胸腔穿刺术,随后测量胸腔积液中的肌酐,是确立明确诊断的简单方法。本文报告两例因子宫和前列腺腺癌导致尿胸的患者。第一例中,尿液通过膀胱渗漏进入腹腔;第二例中,存在肾盂积水伴盆腔破裂。