Retroperitoneal urinoma presenting as a posterior knee sinus following emphysematous pyelitis.
Ibrahim Alshahwani, Martin G Connolly, Riad Al-Harfoushi
✦ AI-curated · Sources linked
Case in brief
A woman in her late 40s presented with abdominal sepsis due to emphysematous pyelitis and a retroperitoneal urinoma. Despite initial treatment, she developed persistent thigh pain and a posterior knee sinus. Imaging revealed infected fluid and gas spreading into the thigh, along with a fistulous connection to the colon. Multidisciplinary management led to her recovery and resolution of sepsis.
What made this case unusual
The case is notable for the atypical presentation of a posterior knee sinus as a result of retroperitoneal infection, highlighting the potential for unusual limb symptoms in such cases.
Diagnostic / clinical pearl
Clinicians should consider the possibility of atypical presentations, such as limb symptoms, in patients with retroperitoneal infections and be prepared to repeat imaging if clinical progress is inadequate.
Why it matters
This case underscores the complexity of managing infections that can lead to unusual complications, emphasizing the need for a multidisciplinary approach in challenging cases.