Published online Apr 24, 2021. doi: 10.5410/wjcu.v10.i1.1
Peer-review started: September 23, 2020
First decision: December 11, 2020
Revised: December 12, 2020
Accepted: April 7, 2021
Article in press: April 7, 2021
Published online: April 24, 2021
Processing time: 203 Days and 8.5 Hours
A 66-year-old lady was referred to urology for a suspected urinoma after retroperioneoscopy done for debridement of a retroperitoneal abscess that developed following a duodenal perforation.
Serous contents of the drain sent for fluid creatinine were elevated confirming this and computed tomography urography findings suggested an upper tract injury with urinoma around the kidney. However, the antegrade nephrostogram suggested otherwise and on flexible cystoscopy and cystogram, an extraperitoneal bladder perforation was instead identified, with tip of retroperitoneal drain sitting inside the bladder.
This case identifies a limitation in the usual diagnostic approach for such injuries and emphasizes the need to exercise caution when managing them especially when they occur after several surgical procedures and in the presence of multiple surgical drains.
Core Tip: This study reports a 66-year-old lady who was referred to urology for a suspected urine leak after retroperitoneoscopy. This case identifies a limitation in the usual diagnostic approach for such injuries and emphasizes the need to exercise caution when managing them especially when they occur after several surgical procedures and in the presence of multiple surgical drains.