Urinoma as an initial presentation of rectosigmoid cancer

Colorectal cancer is the most common primary malignancy of the gastrointestinal tract and may present with a myriad of symptoms. We describe a case of a 36 year old man who presented with a urinoma on the right side secondary to ureteric obstruction at the pelvic brim. The urinoma did not resolve by conservative measures and a laparotomy was performed this revealed an unsuspected recto-sigmoid adenocarcinoma compressing the right lower ureter producing the urinoma. An anterior resection, along-with en bloc resection of the involved ureter and a ureteroureterostomy, was performed. This case illustrates that a rectal cancer may masquerade as a urinoma and surgeons should keep in mind pelvic causes, particularly a mitotic lesion of the rectosigmoid, as a differential diagnosis in such cases so that proper management ensues.

DOI:http://dx.doi.org/10.4038/sljs.v32i1.6878

The Sri Lanka Journal of Surgery 2014; 32(1): 42-44