145-147 UrÝnothorax

Urinothorax is seen quite rarely in the etiology of pleural effusion. Pleural effusion due to urine accumulation in the thorax is known to be secondary to urinary obstruction, trauma, retroperitoneal inflammatory or malignant process, failed nephrostomy or kidney biopsy. The lack of reported cases may be owing to the lack of suspicion. This is a report of a patient with urinothorax, resulting from bilateral hydronephrosis and ureteral obstruction due to bladder carcinoma. He was hospitalised owing to high urea, creatinine, potassium serum levels and oliguria. His chest X-ray showed bilateral small pleural fluid characteristic of transudate, but a high index of suspicion because of the odor of the pleural fluid, alerted us to determine the pleural creatinine level concentration in the pleural fluid. Diagnosis of urinothorax was confirmed by high level of pleural creatinine (5.3 mg/dl).When obstructive uropathy and pleural effusion are associated together, a high index of suspicion is required to avoid for invasive diagnostic studies in a malignancy or another etiology. This may lower the number of cases that fail to identify the origin of pleural effusion and increase the number of urinothorax cases.