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tumor (usually benign) of the sheath surrounding a nerve

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/08 12:51:23」(JST)

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A urinoma, also pararenal pseudocyst, is an encapsulated collection of extravasated urine and typically found in the area adjacent to the kidneys^[1]^[2] or to extend into the retroperitoneum.^[3]

Diagnosis

A urinoma is the result of a breach of the integrity of the pelvis or calices of the kidney or of the ureter.^[4] The urine collection in the perirenal fat causes an inflammatory response with lipolysis resulting in its fibrous encapsulation. Urinomas are usually caused by blunt trauma to the kidneys. While extravasation of urine is common as a result a severe blunt trauma (2-18%), spontaneous resolution is typical, and urinoma formation develops only in few instances.^[5] Less common causes of urinoma development are ureteral obstructions due to cancer, calculus formation, pregnancy, or congenital causes.^[1]^[2]^[3]

Urinomas tend to develop gradually. Symptoms depend on size and location of the lesion.^[3] Eventually local pain and pressure symptoms may become apparent. Biochemical testing of renal function is indicated. Imaging (IVP, ultrasonography, CT scan) will identify the lesion. Image-guided percutaneous needle aspiration is both diagnostic and therapeutic.^[2]

Management

If left untreated, complications may arise including abscess formation, peritonitis, sepsis, and damage to the urinary tract by fibrosis and granuloma formation. It is recommended, as a first step, to drain the lesion with ultrasound or CT guidance.^[1]^[2] If a patient has an underlying obstructive problem it needs to be addressed according to its etiology.^[3]

References

^ ^a ^b ^c Ketabchi AA, Ketabchi M, Narkam M (2009). "Percutaneous Drainage of a Late-onset Giant Posttraumatic Urinoma". Urol J 2009; 6:214-6 6 (3): 214–6. PMID 19711278.
^ ^a ^b ^c ^d Rizvi S, Ibne A, Siddiqui MA, Syed M. "A case report:Urinoma as initial presenting sign of bladder malignancy". Indian Journal of Cancer 2011; 48:514-517 48 (4): 516–7. doi:10.4103/0019-509X.92251or. PMID 22293273.
^ ^a ^b ^c ^d Ona-Olapo A, Oke T, Surenthiran S. "Perirenal urinoma formation in a patient with a complex pelvic cyst". BJUI[1]. External link in |journal= (help)
^ Morano JL, Burkhalter JL (Aug 1985). "Percutaneous catheter drainage of post-traumatic urinoma". J Urol 1985; 134:319-321 134 (2): 319–21. PMID 4020986.
^ Srinath N, Sood R, Rana KVS, Madhusoodhanan P. "Urinoma following blunt renal trauma.". MJAFI 2000; 56:3446.

UpToDate Contents

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1. 婦人科外科手術における尿路損傷：同定およびマネージメント urinary tract injury in gynecologic surgery identification and management
2. 移植腎機能障害をきたす患者の評価および診断 evaluation and diagnosis of the patient with renal allograft dysfunction
3. 医原性尿菅損傷の外科的修復 surgical repair of an iatrogenic ureteral injury
4. 婦人科外科手術における尿路損傷：予防 urinary tract injury in gynecologic surgery prevention
5. 鈍的尿生殖器外傷：初期評価およびマネージメント blunt genitourinary trauma initial evaluation and management

English Journal

Imaging and differential diagnosis of suprarenal masses in the fetus.

Maki E1, Oh K, Rogers S, Sohaey R.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.J Ultrasound Med.2014 May;33(5):895-904. doi: 10.7863/ultra.33.5.895.
Prenatal sonography and magnetic resonance imaging of suprarenal fetal masses is presented, along with clinical information and follow-up. Imaging pearls and differential considerations for each diagnosis will be discussed. Fetal suprarenal mass diagnoses include neuroblastoma, extralobar pulmonary
PMID 24764345

Spontaneous rupture of the renal pelvis presenting as an urinoma in locally advanced rectal cancer.

Garg PK, Mohanty D, Rathi V, Jain BK.
World journal of clinical cases.World J Clin Cases.2014 Apr 16;2(4):108-10. doi: 10.12998/wjcc.v2.i4.108.
A 29-year-old gentleman underwent a transverse colostomy for intestinal obstruction caused by advanced rectal carcinoma. On the 5(th) postoperative day, the patient developed a painful swelling on the right side of the abdomen. The contrast enhanced computed tomography of the abdomen revealed a righ
PMID 24749123

Urinoma in a young child 6 months following dual cadaveric renal transplantation detected on technetium-99m ethylene dicysteine renal dynamic scan confirmed on SPECT/CT.

Singhal A1, Peepre K2, Damle NA1, Mukherjee A1, Bal C1, Tripathi M1.
Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India.Indian J Nucl Med.2014 Apr;29(2):128-30. doi: 10.4103/0972-3919.130326.
PMID 24761075

Japanese Journal

自然尿管破裂を契機に発見された悪性リンパ腫の1例

吉井貴彦,堀口明男,城武卓 [他],戸邉武蔵,早川正道,住友誠,浅野友彦
泌尿器科紀要 56(11), 639-643, 2010-11-00
… Computed tomography showed urinoma around the left kidney and retrograde pyelography showed a diffuse filling defect in the left ureter and a rupture of the upper portion of that ureter. …
NAID 120002694071