title: Hypercreatininemia and hyperglycemia: diabetic nephropathy or "inverted peritoneal auto-dialysis"?
abstract: We describe a case of 51-year-old male with fever, abdominal pain and inguino-scrotal hernia. Laboratory examination revealed hypercreatininemia and hyperglycemia, firstly interpreted as diabetic nephropathy. US and CT scan showed a hernia of the bladder into the scrotum. Surgery revealed multiple bladder perforations with peritoneal diffusion of urine. So, hypercreatininemia was caused by peritoneal reabsorption of urea and creatinine, a condition that may be described as "inverted peritoneal auto-dialysis". Surgical reposition and repairment of the bladder led to rapid normalization of serum urea and creatinine. Discharged diagnosis was intraperitoneal rupture of inguino-scrotal hernia of the bladder in patient with recent onset of diabetes mellitus.
authors.affiliation: Department of Internal Medicine, Catholic University, Rome, Italy. rmanna@rm.unicatt.it
authors.forename: R
authors.initials: R
authors.lastname: Manna
authors.forename: P
authors.initials: P
authors.lastname: Mirk
authors.forename: G
authors.initials: G
authors.lastname: Sallustio
authors.forename: G
authors.initials: G
authors.lastname: Brisinda
authors.forename: D
authors.initials: D
authors.lastname: Izzi
authors.forename: M
authors.initials: M
authors.lastname: La Regina
authors.forename: G
authors.initials: G
authors.lastname: Nucera
authors.forename: G
authors.initials: G
authors.lastname: Maria
authors.forename: M
authors.initials: M
authors.lastname: Montalto
authors.forename: G
authors.initials: G
authors.lastname: Ghirlanda
mesh_terms: D003404:Creatinine / Q000097:blood*; D003928:Diabetic Nephropathies / Q000175:diagnosis*; D003951:Diagnostic Errors; D006552:Hernia, Inguinal / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000150:complications; D001745:Urinary Bladder Diseases / Q000150:complications / Q000175:diagnosis*
chemical_list: D003404:Creatinine