Spontaneous perinephric urinoma presenting as acute abdomen in the third trimester: A case report

Abstract

In the absence of trauma, urinoma due to spontaneous rupture of either the renal parenchyma or the renal collecting system is rare. It is even rarer and difficult to diagnose in pregnancy. Hence, imaging plays a key role in the early identification of this condition and the initiation of management. The primary imaging investigation is ultrasonography and if it is inconclusive, magnetic resonance imaging is the preferred next step. We report a case of a 25-year-old primigravida at 34 weeks of gestation with acute pain in the right loin and loer abdomen without any history of trauma. She had a right-sided hydroureteronephrosis on ultrasound, and later, on MRI, a perinephric urinoma was detected without evidence of any underlying pathology. She underwent double J-stenting and soon became symptom-free. Early detection is required to prevent associated complications such as peritonitis, abscess, and periureteral fibrosis. Therefore, the clinician should have a high index of suspicion when working up flank pain during pregnancy.