title: Hyponatremic renal pseudofailure and massive ascites following normal vaginal delivery: a diagnostic and therapeutic challenge.
abstract: We report the fifth, to our knowledge, published case of spontaneous intraperitoneal bladder rupture after normal, vacuum-assisted in this occasion, vaginal delivery of a 29-year-old female patient. Diagnosis was established not by imaging or intraoperative findings, but, rather, by the examination and comparison of patient's blood, urine, and peritoneal fluid urea and creatinine levels, which, due to the patient's delayed referral and sequent development of uroperitoneum and hyponatremic renal pseudofailure, were abnormal and characteristic of her medical condition. The patient was successfully managed conservatively and was discharged the sixth day after admission. Due to the rare nature of such medical condition and based on the relative literature, we propose a diagnostic and management algorithm for such cases.
authors.affiliation: Department of General Surgery, Nicosia General Hospital, Nicosia, Cyprus. scharalab@yahoo.gr
authors.forename: Sotirios
authors.initials: S
authors.lastname: Charalampidis
authors.forename: Christos
authors.initials: C
authors.lastname: Petrides
authors.forename: Charalampos
authors.initials: C
authors.lastname: Charalampous
authors.forename: Stavros
authors.initials: S
authors.lastname: Stavrou
mesh_terms: D000328:Adult; D001201:Ascites / Q000209:etiology*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D011644:Puerperal Disorders / Q000209:etiology*; D051437:Renal Insufficiency / Q000209:etiology*; D012422:Rupture, Spontaneous; D001745:Urinary Bladder Diseases / Q000150:complications*