Question:

Which of the following are true?
1. Urinothorax is a rare condition.
2. Urinothorax mostly resolve spontaneously.
3. Urinothorax resolves adequately with chest drainage alone.
4. Urinary tract diversion or drainage is not an essential priority in treatment.
5. Both chest drainage and urinary diversion or drainage are required to treat a urinothorax.





Answer:

The correct answers for the question "Which of the following are true?" are:

1. Urinothorax is a rare condition.

5. Both chest drainage and urinary diversion or drainage are required to treat a urinothorax.



Explanation
1. Urinothorax is a rare condition. [Urinothorax is the presence of urine in the pleural cavity. It is a rare and frequently unrecognised cause of transudative pleural effusion].

2. Urinothorax require to be treated. [Prompt recognition of urinothorax and early re establishment of appropriate diversion or distal drainage are important principles of management].

3. Urinothorax require establishing urinary drainage in addition to chest drainage. [Prompt recognition of urinothorax and early re establishment of appropriate diversion or distal drainage are important principles of management].

4. Establishing distal drainage of urine or a suitable urinary diversion are essential to prevent re-accumulation of urine in the chest. [Prompt recognition of urinothorax and early re establishment of appropriate diversion or distal drainage are important principles of management].

5. Both chest drainage and urinary diversion or drainage are required to treat a urinothorax. [Prompt recognition of urinothorax and early re establishment of appropriate diversion or distal drainage are important principles of management].



From the manuscript:
Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy
Radiology Case. 2014 Jan; 8(1):34-40


This article belongs to the GU section.




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From the manuscript

Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy

Free full text article: Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy

Abstract
A 64 year-old male with metastatic prostate adenocarcinoma presented with bilateral hydronephrosis and renal impairment. Bilateral percutaneous nephrostomy drainage followed by ante-grade stenting was done. Shortly afterwards, the patient developed an extensive left-sided pleural effusion. His serum creatinine rose and he became anuric. Emergency pleural aspiration and later, pleural drainage were performed. Pleural aspirate was diagnostic of urinothorax and non contrast CT scan demonstrated a left reno-pleural fistula. The right stent was removed cystoscopically. The left stent could not be removed cystoscopically and was replaced in an ante grade manner through a fresh percutaneous renal approach. This led to cessation of pleural fluid accumulation. The patient was discharged with bilateral ureteric stents and normal renal function. A month later, he had normal renal function, no hydronephrosis and normal chest x-rays.






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