A case of bladder rupture presented as pseudo-renal failure

Abstract

Abstract:Bladder rupture is associated with “pseudo-renal failure,” in which the urine is reabsorbedfrom the peritoneum, resulting in increased serum blood urea nitrogen （BUN） and creatinine levels.　We report a case of ruptured bladder with pseudo-renal failure.　An 80-year-old woman with a history ofovarian cancer surgery visited her previous physician with complaints of mild lower abdominal pain andabdominal distention.　On admission, serum BUN and creatinine levels were elevated, but theyimproved promptly after insertion of an indwelling urethral catheter.　Contrast-enhanced computedtomography （CT） scan did not reveal any specific findings other than ascites effusion, so the diagnosis ofbladder rupture could not be made preoperatively.　Unexplained ascites effusion and unexplained elevationof serum BUN and creatinine levels may indicate a ruptured bladder with pseudo-renal insufficiency.　Contrast-enhanced examination is useful for the diagnosis of bladder rupture, but reevaluation of renalfunction with cystatin C and insertion of an indwelling urethral catheter as diagnostic treatment may alsobe useful.