This case study presents a 26-year-old woman who was admitted to the hospital after a car accident with multiple pelvic and femoral fractures. Imaging showed a peri-hepatic collection that was initially thought to be a hematoma. However, the patient's decreasing urine output and cystography revealing a bladder rupture led to the diagnosis of a peri-hepatic urinoma caused by a bladder injury. Catheterization was sufficient treatment and helped the bladder heal before the patient returned to Hungary for orthopedic procedures.

1. PERI-HEPATIC URINOMA –
A CASE REPORT
Ir. Christodoulou, Z.Koukouritaki, C.Pogonidis,
E.Xenodoxidou,M.Handolias, A.Amanatidou, C.Christianopoulos.
2ND SURGICAL DEPARTMENT, PAPANIKOLAOU
HOSPITAL,THESSALONIKI
PURPOSE: This case study presents a peri-
hepatic urinoma mimicking a perihepatic
hematoma.
MATERIALS AND METHODS: A Hungarian 26
year- old woman was admitted after a car
accident in our Hospital, having multiple pelvic
fractures and bilateral femoral fractures. The
patient reported a non- typical abdominal pain
and bowel mobility was slightly affected. The
clinical examination was not indicating intra-
abdominal injuries, but the blood test (Ht= 26%)
and the abdominal CT, showing a perihepatic
collection, like a hematoma, complicated the
diagnostic procedure. Hematuria was present in
the first 48 hours and was explained by the pelvic
fractures.
RESULTS: Because the hemodynamic status of
the patient was not matching to constant intra –
abdominal hemorrhage, laparotomy was
postponed. The patient presented a decrease in
urine volume the second post-traumatic day. With
the infusion of an opaque solution via a Folley
catheter a bladder rupture was imagined and final
diagnosis was perihepatic urinoma after bladder
trauma. Maintenance of the Folley catheter was
adequate treatment for healing of the bladder.
The scenario was complicated because the
patient would travel to Hungary after the
orthopedic operations.
CONCLUSION: It is wise to avoid an early
laparotomy in stable patients with multiple
injuries, especially when time for repeating
assessment is available.