Pseudorenal failure due to intraperitoneal bladder rupture after blunt trauma: Usefulness of examining ascitic fluid sediment

Yusuke Kuroki, Tohru Mizumasa, Tadashi Nagara, akihiro tsuchimoto, Hideki Yotsueda, Kiyoshi Ikeda, Tetsuro Takesue, Hideki Hirakata

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Abstract

A 42-year-old man noted decreased urine output and visited our emergency department. He said that 3 days previously, he had gotten drunk and fallen down a set of stairs. Blood tests and abdominal contrast-enhanced computed tomography revealed no abnormalities. A serum creatinine level of 5.89 mg/dL led to a diagnosis of acute renal failure and his hospitalization. After admission, his ascitic fluid level gradually increased, suggesting urine leakage into the peritoneal cavity. Microscopic examination of his ascitic fluid sediment revealed the presence of hyaline casts enclosing renal tubular epithelial cells. Cystography demonstrated contrast medium leakage into the peritoneal cavity, which led to a diagnosis of bladder rupture. Examination of ascitic fluid sediment is simple and very useful for diagnosing bladder rupture.

Original languageEnglish
Pages (from-to)1326.e1-1326.e3
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number7
DOIs
Publication statusPublished - Jan 1 2012
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Emergency Medicine

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