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 perihepatic 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 intraabdominal 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.