Abstract

Iatrogenic Urinomas Identified by 99mTc DTPA Renal Scintigraphy

Padma Subramanyam, Shanmuga Sundaram Palaniswamy, Anshu Tewari and Praveen Kumar SLG

Urine leaks can occur from the kidney, ureter, bladder, and urethra, and is usually attributed to an iatrogenic cause. Urinomas are collection of extravasated urine that may be initially occult and may lead to complications such as abscess formation and electrolyte imbalances if not promptly diagnosed and appropriately managed. It is important not only to diagnose urine leaks but also to determine their cause and extent, thus imaging specialists play a key role. We present two iatrogenic cases of urinomas, one from the ureter and the other from the kidney that were diagnosed by 99mTechnetium Diethylene triamine penta acetic acid (99mTc DTPA) renogram. Initially contrast enhanced computed tomography reported the first case to be a large ovarian cyst, while the other case was reported to be a pyogenic abscess. 99mTc DTPA renogram is a highly reliable, non invasive investigation with a physiological basis. It can be used not only for diagnosing urine leaks but also for assessing individual renal function as there may be an underlying renal disarrangement in such patients.