Point-of-care ultrasound assessment of pelvic urine leakage in two patients presenting with flank pain: a case series and literature review

Abstract

Abstract Background: Urinoma, a rare condition resulting from urine leakage due to trauma to the kidney, bladder, or urethra, is typically diagnosed using enhanced computed tomography with delayed imaging. This report presents two cases of urinoma likely caused by overdistention of the renal pelvis following excessive fluid intake and the presence of a ureteral stone. Case presentation: We present two cases of 36-year-old and 38-year-old patients who presented with flank pain. Point-of-care ultrasound played a pivotal role in identifying perinephric fluid in Morrison's space and the splenorenal space, respectively. These ultrasound findings guided further investigations, leading to definitive diagnoses via abdominal pelvic CT scans. Comprehensive lab tests were also conducted. Treatment involved the successful placement of a double J stent into the renal pelvis over the wire under fluoroscopic guidance, which significantly reduced the patients' complaints during follow-up. Antibiotic treatment was continued post-procedure. Conclusions: This study demonstrates the rare occurrence of urinoma from ureteral lithiasis, emphasizing the importance of prompt diagnosis and treatment.