Urinothorax, another complication of bladder tumor: case report

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Abstract

Background: Rupture of the fornix is a rare and serious urological complication of obstructive pathologies. The main cause is ureteral stone, but rarely a bladder tumor. Described complications of fornix rupture are superinfection, perirenal abscesses and even sepsis, but not urinothorax. Case presentation: Patient of 56 years old, active and chronic smoker, was hospitalized for anemia and obstructive renal failure on a non-documented bladder tumor; clinically, he was presented with hematuria and an intense right loin pain associated with homolateral basithoracic pain and dyspnea. The CT scan without injection showed a right perirenal collection with bilateral renal dilatation on endo-vesical tumor and a right pleural effusion of less abundance. The ratio of pleural fluid creatinine to blood creatinine was greater than 1, confirming urinothorax. As an emergency, a percutaneous nephrostomy was performed. After clinical stabilization, the patient underwent a trans-urethral resection of the bladder and derivation by a double j stent. The ultimate evolution was favorable. Conclusions: Beyond the metabolic complications secondary to obstructions, mechanical complications, which can also be fatal, must be included.

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Nedjim, S. A., Abdi, E. M., Hagguir, H., Moataz, A., Dakir, M., Debbagh, A., & Aboutaieb, R. (2021). Urinothorax, another complication of bladder tumor: case report. African Journal of Urology, 27(1). https://doi.org/10.1186/s12301-021-00228-9

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