A middle-aged male presented with abdominal pain and ascites following a fall in alcoholic intoxicated state. Evaluation revealed microscopic hematuria and severe renal failure. Ascitic fluid analysis showed high urea and creatinine values suggesting it to be a urinary ascites. Retrograde cystography confirmed intraperitoneal bladder rupture. Following continuous bladder drainage ascites subsided and serum creatinine has reduced to 3 mg/dL. This case report highlights the importance of ascitic fluid analysis as a pointer to diagnose urinary ascites secondary to intraperitoneal bladder rupture.
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