title: Pseudorenal failure due to intraperitoneal bladder rupture after blunt trauma: usefulness of examining ascitic fluid sediment.
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.
authors.affiliation: Nephrology & Dialysis Center, Fukuoka Red Cross Hospital, Fukuoka, Japan. ykuroki@fukuoka-med.jrc.or.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kuroki
authors.forename: Tohru
authors.initials: T
authors.lastname: Mizumasa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nagara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tsuchimoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Yotsueda
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ikeda
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Takesue
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirakata
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry* / Q000166:cytology; D003404:Creatinine / Q000097:blood; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology*; D012421:Rupture / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis*
chemical_list: D003404:Creatinine