Urine in the lung: An uncommon cause of transudative pleural effusion
Urinothorax [UT], the accumulation of urine in the pleural space, is an uncommon cause of pleural effusions resulting from trauma, obstruction, or iatrogenic causes. Thoracentesis with pleural fluid analysis and evaluation of biochemical characteristics, such as pleural fluid creatinine (PCr) to ser...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007120304342 |
| _version_ | 1818380795174191104 |
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| author | Abigayle Sullivan Theresa Lanham Nidrit Bohra Brigid Ellis Daron Kahn |
| author_facet | Abigayle Sullivan Theresa Lanham Nidrit Bohra Brigid Ellis Daron Kahn |
| author_sort | Abigayle Sullivan |
| collection | DOAJ |
| description | Urinothorax [UT], the accumulation of urine in the pleural space, is an uncommon cause of pleural effusions resulting from trauma, obstruction, or iatrogenic causes. Thoracentesis with pleural fluid analysis and evaluation of biochemical characteristics, such as pleural fluid creatinine (PCr) to serum creatinine ratio (Scr), is necessary to establish this diagnosis. This case illustrates a 93 year old man with a complicated past medical history including chronic kidney disease stage 4, adenocarcinoma of the prostate status post brachytherapy complicated by proctitis, high grade transitional cell carcinoma of the right kidney with right hydronephrosis, and recurrent hematuria who was hospitalized for worsening hematuria and suprapubic pain. The patients CXR showed a large right pleural effusion. A repeat thoracentesis was performed removing 1.85L clear yellow fluid. PCr and SCr were 4.1 mg/dl and 3.94 mg/dL respectively. This confirmed the diagnosis of UT with a PCr to SCr ratio of 1.04. Again, diagnosis requires pleural fluid analysis and is associated with a paucicellular, transudative effusion with an ammonia-like odor, acidotic pH less than 7.4, and a PCr to SCr ratio greater than 1.0. Management is dependent on correcting the underlying pathology, such as repairing traumatic GU injury or obstruction. |
| first_indexed | 2024-12-14T02:24:21Z |
| format | Article |
| id | doaj.art-21a51a2898da477c83d66e0cc9dc4221 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-12-14T02:24:21Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-21a51a2898da477c83d66e0cc9dc42212022-12-21T23:20:25ZengElsevierRespiratory Medicine Case Reports2213-00712020-01-0131101220Urine in the lung: An uncommon cause of transudative pleural effusionAbigayle Sullivan0Theresa Lanham1Nidrit Bohra2Brigid Ellis3Daron Kahn4Department of Internal Medicine, Reading Hospital – Tower Health System, PA, USA; Corresponding author. Department of Internal Medicine Reading Hospital - Tower Health System, PA, USA.Department of Internal Medicine, Reading Hospital – Tower Health System, PA, USADepartment of Internal Medicine, Reading Hospital – Tower Health System, PA, USADepartment of Nephrology, Reading Hospital – Tower Health System, PA, USADepartment of Pulmonary and Critical Care, Reading Hospital – Tower Health System, PA, USAUrinothorax [UT], the accumulation of urine in the pleural space, is an uncommon cause of pleural effusions resulting from trauma, obstruction, or iatrogenic causes. Thoracentesis with pleural fluid analysis and evaluation of biochemical characteristics, such as pleural fluid creatinine (PCr) to serum creatinine ratio (Scr), is necessary to establish this diagnosis. This case illustrates a 93 year old man with a complicated past medical history including chronic kidney disease stage 4, adenocarcinoma of the prostate status post brachytherapy complicated by proctitis, high grade transitional cell carcinoma of the right kidney with right hydronephrosis, and recurrent hematuria who was hospitalized for worsening hematuria and suprapubic pain. The patients CXR showed a large right pleural effusion. A repeat thoracentesis was performed removing 1.85L clear yellow fluid. PCr and SCr were 4.1 mg/dl and 3.94 mg/dL respectively. This confirmed the diagnosis of UT with a PCr to SCr ratio of 1.04. Again, diagnosis requires pleural fluid analysis and is associated with a paucicellular, transudative effusion with an ammonia-like odor, acidotic pH less than 7.4, and a PCr to SCr ratio greater than 1.0. Management is dependent on correcting the underlying pathology, such as repairing traumatic GU injury or obstruction.http://www.sciencedirect.com/science/article/pii/S2213007120304342Respiratory failureThoracic surgeryQuality of life |
| spellingShingle | Abigayle Sullivan Theresa Lanham Nidrit Bohra Brigid Ellis Daron Kahn Urine in the lung: An uncommon cause of transudative pleural effusion Respiratory Medicine Case Reports Respiratory failure Thoracic surgery Quality of life |
| title | Urine in the lung: An uncommon cause of transudative pleural effusion |
| title_full | Urine in the lung: An uncommon cause of transudative pleural effusion |
| title_fullStr | Urine in the lung: An uncommon cause of transudative pleural effusion |
| title_full_unstemmed | Urine in the lung: An uncommon cause of transudative pleural effusion |
| title_short | Urine in the lung: An uncommon cause of transudative pleural effusion |
| title_sort | urine in the lung an uncommon cause of transudative pleural effusion |
| topic | Respiratory failure Thoracic surgery Quality of life |
| url | http://www.sciencedirect.com/science/article/pii/S2213007120304342 |
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