URINARY ASCITES WITH PELVIC URINOMA PRESENTING AS OVARIAN NEOPLASM - CLINICAL AND ULTRASONOGRAPHIC FEATURES

Background: The majority of ureteric injuries associated with an opera tion are the result of gynecologic surgery. Thus, gynecologists must b e aware of this risk and appreciate that ureteric injury can present l ate and in an unusual manner. Case: A 26-year-old woman presented with gross abdominal distention 4 months after total abdominal hysterectom y. Ultrasonography demonstrated a large volume of ascitic fluid and a complex cyst arising from the left ovary. Serum blood urea nitrogen an d creatinine were normal. Laparotomy showed a mass of 1-2-cm cysts (ur inomas) on the pelvic peritoneum and tubo-ovarian surfaces and a right hydroureter with a right ureteric fistula at the level of the ureteri c tunnel. A ureteroneocystostomy was performed. Conclusion: Ureteroper itoneal fistula with urinary ascites is a rare complication of pelvic surgery. Intravenous urography or computed tomography scan would have helped establish the diagnosis.