Pleural Effusion-Urinothorax

Epidemiology

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Etiology

  • Renal calculi:
  • Urinary tract malignancy:
  • Urinary tract surgery:
  • Trauma to urinary tract:

Physiology

  • Urinary tract disruption or obstruction -> urine accumulates in retroperitoneum -> dissects through fascial planes or travels through lymphatics into the pleural space

Diagnosis

  • Pleural fluid:
    • Appearance: like urine
    • pH: low (urinothorax is the only transudate with a low pH)
    • LDH ratio: low
    • Total protein ratio: low
    • Pleural: Serum creatinine ratio: >1.0 (diagnostic of urinothorax)
  • CXR/Chest CT Patterns
    • Pleural effusion:

Clinical

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Treatment

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References

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