Abdominal Pain, Hyperkalemia, and Elevated Creatinine after Blunt Trauma: Bladder Rupture and Pseudo–Acute-Kidney-Injury.

Abstract

A 40-year-old man involved in trauma presented with abdominal pain and ascites. He was referred to nephrology for elevated creatinine and hyperkalemia. Initial imaging showed diffuse free fluid in the abdomen and pelvis without solid organ injury. Paracentesis drained 1.5L of yellow fluid notable for a creatinine of 2259 μmol/L. Intraperitoneal urinary bladder rupture was diagnosed and surgically repaired. Within 24 hours, creatinine had normalized consistent with a presentation of pseudo-acute-kidney-injury. This case and a literature review reveals that this condition is often delayed in diagnosis or misdiagnosed altogether.