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OP-087 Different etiologies of encapsulated collections of urine in newborns
  1. Ruya Meric1,
  2. Zeynep Alp Unkar2,
  3. Ersin Ulu2,
  4. Mehmet Vural2,
  5. Esra Karabağ Yılmaz3,
  6. Ayşe Ağbaş3
  1. 1Istanbul University-Cerrahpaşa, Department of Pediatrics
  2. 2Istanbul University-Cerrahpaşa, Department of Pediatrics, Neonatal Intensive Care
  3. 3Istanbul University-Cerrahpaşa, Department of Pediatrics, Pediatric Nephrology


Aim Urinomas are encapsulated collections of extravasated urine. They occur due to stones, surgery, tumors, posterior urethral valves, and trauma. They are rarely seen in newborns, with posterior urethral valve being the most common cause. We will present three urinoma cases with different etiologies from Cerrahpaşa Neonatal Intensive Care Unit.

Material and Method A term baby was administered to the emergency room post-discharge. The infant was intubated due to respiratory distress and had absence of urine output. Tests revealed high creatinine at and urea. An ultrasound showed a multicystic dysplastic kidney on the left, pelvicocaliceal system dilation on the right with a urinoma in the perirenal area. Emergency peritoneal dialysis was initiated, and a percutaneous nephrostomy catheter was placed. A palpable mass was detected in a preterm baby’s abdomen during the delivery room examination. Initial investigations for neuroblastoma revealed elevated NSE, normal AFP and normal urine VMA. The ultrasound showed significantly dilated ureters, diffusely thickened bladder wall, and a prominent posterior urethra. Bilateral VUR was identified on voiding cystourethrography, and the urinoma was diagnosed. Surgical intervention was planned.

Results An antenatally diagnosed baby was delivered with omphalocele and bladder exstrophy. During further investigation for associated anomalies, ECHO revealed interruption of the inferior vena cava (IVC) with hepatic veins directly draining into the right atrium, and the IVC connecting to the heart via the azygos vein. Ultrasound identified an accessory spleen. After the primary repair of the omphalocele and bladder extrophy, creatinine levels increased and urinoma at the lower pole of the right kidney was observed. The patient was transferred to pediatric surgery unit for further management.

Conclusions The formation of a urinoma is a rare complication of lower urinary system obstruction. It should be considered according to symptoms and laboratory findings associated with obstruction. If there are respiratory symptoms or compromised kidney functions, urgent intervention is required.

  • newborn
  • urinoma
  • PUV
  • VUR
  • UVJ

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