Posttraumatic Haematuria with Pseudorenal Failure: A Diagnostic Lead for Intraperitoneal Bladder Rupture

Abstract

Bladder rupture is a very morbid injury following blunt or penetrating lower abdominal trauma. Prompt diagnosis is crucial to initiate optimal treatment. Intraperitoneal bladder rupture is associated with haematuria and biochemical features of renal failure. Cystogram is diagnostic. Immediate open surgical repair is the main stay of treatment. A case of intraperitoneal rupture diagnosed preoperatively by the presence of haematuria and pseudorenal failure is presented to highlight the association of posttraumatic haematuria and pseudorenal failure in such injuries.

An interesting presentation of invasive bladder carcinoma as pseudo renal failure

“…In adulthood, the commonest cause of such a presentation is the delayed diagnosis of a spontaneous or traumatic bladder perforation. [6][7][8][9][10] Bladder cancer is one such rare cause of spontaneous bladder perforation that can lead to this clinical picture. [11][12][13][14][15][16][17][18][19] Interestingly, most of the cases of bladder cancer who had spontaneous bladder perforations were in fact, squamous cell carcinomas, like our index case, probably denoting more extensive permeation of wall.…”

“…20 Clinicians should distinguish pseudo renal failure from true renal failure based on laboratory analysis of peritoneal fluid, which has higher levels of urea, creatinine, and potassium than serum. [1][2][3][4][5][6][7][8][9][10] Emergency management of these patients depend on the clinical scenario. Unfortunately, most of these patients are elderly and are moribund at presentation, thereby precluding any major definitive surgery like a radical cystectomy.…”