Undrained Infected Urinoma After Blunt Renal Trauma.

A 65-year-old man presented with left-sided flank pain and distended abdomen after being returned by airplane from abroad where he had experienced a motorcycle accident with polytrauma (grade III splenic and grade IV renal rupture, bilateral lung contusion, left-sided fracture of the orbita and sinus maxillaris) 22 days earlier. Nine days after trauma, left-sided renal pseudoaneurysm was treated with coil embolization. Neither a ureteral stent nor a percutaneous drain was placed. At presentation, leukocytes (18.9 GPt/L, normal: ≤10), hemoglobin (5.60 mmol/L, normal: 8.70-11.2) and C-reactive protein (283 ng/mL, normal: <5) were abnormal. Creatinine was normal (96 μmol/l, normal: 59-104). A computed tomography (CT) scan obtained 1 day earlier revealed a complete left-sided renal rupture with large urinoma. The minimal distance between viable parenchyma of upper and lower pole was more than 5 cm (Fig. 1). The patient was otherwise stable after successful conservative treatment of the other injuries elsewhere. There was no history of a compromised immune system.