Magnetic resonance-retrograde pyelography: A novel technique for evaluation of chyluria

Goel, Apul; Goyal, Neeraj Kumar; Parihar, Anit; Singh, Ragini

doi:10.4103/0970-1591.124221

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…Although the contrast agent is not injected into the bloodstream, life-threatening anaphylactic reactions are still a possible complication if the contrast media is absorbed through the urothelium. Therefore, it should not be performed in patients with known contrast media allergies [ 11 ]. To avoid the use of ionic contrast media and radiation exposure, while also offering a simultaneous detailed intra-abdominal evaluation, MR retrograde pyelography may be used.…”

Section: Discussionmentioning

confidence: 99%

The Case of a 15-Year-Old With Non-Parasitic Chyluria

Krstić¹,

Šoštarič²,

Caf³

et al. 2021

Cureus

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Chyluria is defined by the presence of chyle in urine, and is caused by a communication between the lymphatic and urinary system. Commonly, it is characterised by the excretion of milky white urine, which is present in up to 70% of chyluria cases. The prevalent cause for chyluria in Asia is filariasis with Wuchereria bancrofti. Non-parasitic chyluria is more common in western countries and is usually subsequent to traumatic factors, infections, or tumours. The occurrence of non-parasitic chyluria in the absence of trauma, iatrogenic or other, is exceedingly rare. The lymphatic system is rather challenging to visualize. Herein, we present a case of non-parasitic chyluria and our approach of combining different complementing imaging modalities, such as contrast-enhanced ultrasound (CEUS) retrograde pyelography and magnetic resonance (MR) lymphography.

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Section: Discussionmentioning

confidence: 99%

The Case of a 15-Year-Old With Non-Parasitic Chyluria

Krstić¹,

Šoštarič²,

Caf³

et al. 2021

Cureus

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“…While unable to directly demonstrate the site of fistulous communication, MRI may show multiple tubular, tortuous, fluid-filled structures in the retroperitoneum corresponding to retroperitoneal and perirenal lymphangiectasia [13] . Interestingly, the association between retrograde pyelography and MRI seems to be effective in the evaluation of chyluria due to a detailed intra-abdominal evaluation [14] . CT performed after diagnostic lymphangiography has been used as a complementary tool for diagnostic lymphangiography [15] .…”

Section: Discussionmentioning

confidence: 99%

Trans-urethral resection of bladder tumor (TURBT) and radiofrequency ablation of renal tumor: Rare etiologies of chyluria

Assaker

Hasbani

Vargas

et al. 2020

Radiology Case Reports

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Chyluria is a rare entity which is caused by abnormal communication between the lymphatic system and the urinary tract, which allows the passage of chyle into the urine. Whenever symptomatic, chyluria presents with lower urinary tract symptoms such as dysuria and hematuria. Multiple imaging modalities can aid in diagnosis such as lymphoscintigraphy, retrograde pyelography, CT scan of the abdomen and pelvis, and magnetic resonance imaging. Numerous etiologies are associated with chyluria among which are surgical interventions. Partial and radical nephrectomy have been reported in a number of symptomatic and asymptomatic cases, while radiofrequency ablation of renal tumors has been very rarely reported. Herein, we report 2 cases of chyluria; one caused by trans-urethral resection of a bladder tumor and another by radiofrequency ablation of a renal oncocytoma. Fat-fluid level in the urinary bladder was seen on both precontrast and postcontrast images of CT scan of the abdomen and pelvis. Cystoscopy demonstrated no evidence of any abnormality of the urinary bladder.

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“…MR retrograde pyelography avoids radiation exposure and the use of ionic contrast. It provides detailed evaluation of abdominal anatomy, which is important in non-filarial chyluria 67. The modality to use will depend on the availability, technical expertise and the depth of anatomical correlation required.…”

Section: Discussionmentioning

confidence: 99%

Chyluria in non-filarial endemic areas: an internist’s perspective

Tan

2017

BMJ Case Reports

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A 60-year-old Chinese woman presented with intermittent, painless, gross haematuria and subsequently complained of persistent milky urine. The diagnosis of chyluria was confirmed after cystoscopy demonstrated ureteric milky fluid discharge which had elevated levels of triglycerides. The patient did not travel to filarial endemic areas and her serum circulating filarial antigen was negative. Intravenous pyelography with CT of the abdomen did not reveal any masses or obstruction. It was determined that her chyluria was non-parasitic in origin and her symptoms improved with a low fat, high-protein diet. However, her chyluria recurred 1 year later, resulting in hypoalbuminaemia and proteinuria. Her symptoms resolved and her albumin levels normalised with adherence to dietary modifications.

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Magnetic resonance-retrograde pyelography: A novel technique for evaluation of chyluria

Cited by 7 publications

References 5 publications

The Case of a 15-Year-Old With Non-Parasitic Chyluria

The Case of a 15-Year-Old With Non-Parasitic Chyluria

Trans-urethral resection of bladder tumor (TURBT) and radiofrequency ablation of renal tumor: Rare etiologies of chyluria

Chyluria in non-filarial endemic areas: an internist’s perspective

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