Urinary Ascites and Renal Failure from Unrecognized Bladder Rupture

KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications

“…Rarely, trauma or iatrogenic origin can cause urinary ascites by injury of the bladder or ureter. Elevated levels of urea and creatinine in the ascites fluid can be clues for diagnosis [ 50 ]. When the cause of ascites remains uncertain, laparotomy or laparoscopy with peritoneal biopsy for histology and culture remains the gold standard.…”

Pseudo-acute Renal Failure due to Intraperitoneal Urine Leakage

“…However, ensuring adequate drainage of the urinary ascites fluid via paracentesis and the placement of a Foley catheter can help to improve the patient's symptoms and normalize the serum creatinine level. The serum creatinine level usually returns to normal within 48 hours (2,5,6,13,14,16,17). Accordingly, the serum creatinine level in our patient quickly returned to normal following the insertion of a urinary catheter, and the ascites subsequently resolved.…”

Management of blunt intraperitoneal bladder rupture: Case report and literature review

“…While extraperitoneal ruptures can generally be managed non-operatively with a bladder catheter, guidelines from both the American Urologic Association and the Eastern Association for the Surgery of Trauma advocate for surgical repair of intraperitoneal lacerations [6,9]. Free urine in the abdomen and pelvis leads to acute renal failure and sepsis, which is responsible for mortality rates over 20% when not promptly identified [10]. Our patient exhibited acute kidney injury and neurologic manifestations within hours of injury.…”