Infected urinoma presenting as a flank mass: A case report

Abstract

Rationale: Infected urinomas are rare complications of urinary tract obstruction and may mimic renal abscess or pyonephrosis. Presentation as a palpable flank mass is highly unusual. Patient’s concern: An 84-year-old man with fever, flank pain, and a firm right flank mass. Imaging revealed an acute multiloculated infected urinoma communicating with the proximal ureter, associated with a ureteric calculus. Diagnosis: Infected urinoma. Interventions: He was treated with antibiotics, percutaneous drainage, and nephrostomy. Outcomes: Recurrence occurred three months later due to unresolved obstruction, requiring repeat drainage. Definitive surgical management was deferred due to advanced age and comorbidities, highlighting challenges in high-risk patients. Lessons: This case highlights the importance of considering urinoma in the differential diagnosis of flank masses, the complementary roles of multimodal imaging for accurate diagnosis, and the importance of definitive management of urinary obstruction to prevent recurrence.

Keywords

Urinoma / Urosepsis / Flank mass / Obstructive uropathy / Percutaneous drainage

Conflict of interest statement

The authors report no conflict of interest.

Ethical approval statement

This report complies with institutional ethics guidelines (Policy and procedure number: 85040-PP-002), which waives consent for single-patient case reports without identifiers. Patient data were anonymized in the report, and consent to the use of patient photo is not required.

Funding

This study received no extramural funding.

Data availability statement

The data supporting the findings of this study are available from the corresponding author upon request.

Authors’ contributions

All authors have made significant contributions to the manuscript. NT: literature review, drafting and editing of the manuscript. WYT: Manuscript final editing and review. EO: Conceptualization, Supervision, manuscript final editing and review. All authors read and approved the final version of the manuscript.

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