Renal Failure Following Traumatic Bladder Rupture: A Case Report

When the bladder ruptures into the peritoneal cavity, urine rich in creatinine and urea can accumulate freely within the abdomen.The resulting rise in serum creatinine and urea therefore stems from passive reabsorption of these solutes across the peritoneal membrane rather than from an actual decline in kidney function, and the calculated glomerular filtration rate (GFR) returns to normal shortly after the bladder is repaired and the peritoneal cavity washed out.We describe a previously healthy six-year-old girl who developed pseudo-renal failure from an intraperitoneal bladder rupture sustained one day earlier during a fall from standing height.She presented to the emergency department with severe generalized abdominal pain and macroscopic hematuria with preserved diuresis.The examination revealed a patient stable hemodynamically and respiratorily, with ascites and general tenderness without abdominal guarding, the pain being most pronounced in the suprapubic area.Blood tests showed elevated creatinine levels at 61.64 mg/L and a urea level at 2.66 g/L.The abdominal and pelvic CT scan revealed a large amount of ascites, with identification of the distal end of the urinary catheter in the intra-abdominal cavity through a defect in the upper wall of the bladder measuring 9 mm in diameter, and extravasation of contrast medium during the urinary phase.However, the liver, spleen, pancreas, kidneys, and ureters appeared normal.Through this observation, we raise awareness of the possibility of bladder rupture in the presence of acute renal failure even without a history of severe trauma.