Pseudo-renal Failure: Bladder Rupture with Urinary Ascites

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2015 Nov 22

PMID 26590189

Citations 10

Authors

Masami Matsumura

Naokatsu Ando

Ayako Kumabe

Gurpreet Dhaliwal

Affiliations

Soon will be listed here.

Abstract

We report a case of pseudo-renal failure caused by urinary ascites due to spontaneous bladder rupture following transurethral resection of a bladder tumour (TUR-BT). A 63-year-old man presented with 2 months of abdominal distension due to ascites. Laboratory findings showed elevated serum creatinine and hyperkalaemia. Peritoneal fluid urea, creatinine and potassium levels were greater than those in serum levels. CT scan showed partial wall thinning in the bladder wall, and cystography indicated fragility in the dome where the latest TUR-BT was performed. Pseudo-renal failure (laboratory abnormalities of acute kidney injury in the setting of normal kidney function) from urinary ascites and reverse intraperitoneal dialysis was diagnosed. Symptoms and laboratory abnormalities improved promptly with insertion of a urinary catheter. This report aims to increase recognition of urinary ascites when a patient with genitourinary surgical procedures or radiation therapy, or blunt abdominal trauma, presents with ascites and elevated creatinine simultaneously.

Citing Articles

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References

Kim J, Yang W . Delayed spontaneous perforation of urinary bladder with intraperitoneal seeding following radical transurethral resection of invasive urothelial cancer: a case report. BMC Res Notes. 2014; 7:167. PMC: 3994548. DOI: 10.1186/1756-0500-7-167. View

Sherman R, EISINGER R, Weinstein M, Samel J . Cefoxitin-induced pseudo acute renal failure. Clin Ther. 1981; 4(2):114-7. View

Hayashi W, Nishino T, Namie S, Obata Y, Furukawa M, Kohno S . Spontaneous bladder rupture diagnosis based on urinary appearance of mesothelial cells: a case report. J Med Case Rep. 2014; 8:46. PMC: 3943372. DOI: 10.1186/1752-1947-8-46. View

Dooldeniya M, Khafagy R, Mashaly H, Browning A, Sundaram S, Biyani C . Lower abdominal pain in women after binge drinking. BMJ. 2007; 335(7627):992-3. PMC: 2072017. DOI: 10.1136/bmj.39247.454005.BE. View

Kuroki Y, Mizumasa T, Nagara T, Tsuchimoto A, Yotsueda H, Ikeda K . Pseudorenal failure due to intraperitoneal bladder rupture after blunt trauma: usefulness of examining ascitic fluid sediment. Am J Emerg Med. 2011; 30(7):1326.e1-3. DOI: 10.1016/j.ajem.2011.06.033. View

Pintar T, Wilke R . Urinary ascites: spontaneous bladder rupture presenting as acute oliguric renal failure. Am J Med. 1998; 105(4):347-9. DOI: 10.1016/s0002-9343(98)00264-2. View

Okafor C, Gupta M . Quiz page. Pseudo renal failure secondary to intraperitoneal bladder perforation during cesarean delivery. Am J Kidney Dis. 2008; 52(2):A37-9. DOI: 10.1053/j.ajkd.2008.03.032. View

Jones A, Armitage J, Kastner C . Conservatively managed spontaneous intraperitoneal bladder perforation in a patient with chronic bladder outflow obstruction. Urol Ann. 2014; 6(4):370-2. PMC: 4216550. DOI: 10.4103/0974-7796.141017. View

Mokoena T, Naidu A . Diagnostic difficulties in patients with a ruptured bladder. Br J Surg. 1995; 82(1):69-70. DOI: 10.1002/bjs.1800820124. View

10.

Martens P . Pseudorenal failure secondary to reversed intraperitoneal autodialysis. Case Rep Nephrol. 2014; 2013:982391. PMC: 3913422. DOI: 10.1155/2013/982391. View

11.

. Abstracts from the 37th Annual Meeting of the Society of General Internal Medicine, 2014, San Diego, CA, USA. J Gen Intern Med. 2014; 29 Suppl 1:1-545. PMC: 4429500. DOI: 10.1007/s11606-014-2834-9. View

12.

Kong J, Bultitude M, Royce P, Gruen R, Cato A, Corcoran N . Lower urinary tract injuries following blunt trauma: a review of contemporary management. Rev Urol. 2011; 13(3):119-30. PMC: 3222924. View

13.

Adla M, Gonzalez-Paoli J, Rifkin S . Isopropyl alcohol ingestion presenting as pseudorenal failure due to acetone interference. South Med J. 2009; 102(8):867-9. DOI: 10.1097/SMJ.0b013e3181ac12f1. View

14.

Nakajima M, Inoue T, Kato H, Nangaku M . Pseudo-acute kidney injury secondary to intravenous dexamethasone. Am J Kidney Dis. 2014; 65(2):344. DOI: 10.1053/j.ajkd.2014.09.020. View

15.

Deck A, Shaves S, Talner L, Porter J . Computerized tomography cystography for the diagnosis of traumatic bladder rupture. J Urol. 2000; 164(1):43-6. View

16.

Williamson L, New D . How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology. BMJ Case Rep. 2014; 2014. PMC: 4170516. DOI: 10.1136/bcr-2014-204754. View

17.

Arnold W, Redman J, Seibert J . Analysis of peritoneal fluid in urinary ascites. South Med J. 1986; 79(5):591-4. DOI: 10.1097/00007611-198605000-00018. View