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Document Details :
Title: Ascites en acute nierinsufficiëntie
Author(s): VAN MOERKERCKE W, CARDOEN L, HOLVOET A, BILLIET I, MEEUS G, D’HEYGERE F
Journal: Tijdschrift voor Geneeskunde
Volume: 64 Issue: 17 Date: 2008
A 65-year-old lady with ascites and acute kidney failure
A 65-year-old lady suffered from progressive abdominal distension and pain. She was hospitalized because ascites was presumed, and confirmed by echography. Acute renal failure was revealed by the laboratory results, though no anury or oligury did occur. After adequate fluid correction by a central venous line no substantial improvement could be obtained.
The analysis of the free intra-abdominal fluid which contained a high level of ureum and creatinine suggested an urinary origin of the ascites; thus a cystography was performed confirming the intraperitoneal leakage of urine. After evacuating a great amount of ascites and sondage of the bladder, renal function improved. No refractory ascites was found.
Facing ascites in a patient with a history of radiation therapy for a bladder or gynaecological disease, a clinician should be aware of intraperitoneal urine leakage. The suspicion has to be greater when a recent cystoscopy has been performed.