自发性膀胱破裂致假性肾衰竭

Pseudo-renal failure caused by spontaneous bladder rupture

54岁男性患者,醉酒后次日清晨出现腹胀、肉眼血尿,血清肌酐(SCr)急剧上升,迅速进展至无尿,在当地医院接受血液透析治疗。期间持续腹胀、腹痛,大量腹水连续引流无缓解。在国家肾脏疾病临床医学研究中心查腹水SCr升高,行CT尿路造影发现膀胱前壁局部缺损,确诊自发性膀胱破裂和假性肾衰竭。留置导尿管后尿量恢复,SCr迅速降至正常。两周后复查膀胱破裂口愈合,拔除导尿管,完全康复。

A 54-year-old male patient presented with abdominal distension,gross hematuria,and a sharp increase in serum creatinine after awake from a drunken sleep.He rapidly progressed to anuria and was treated with hemodialysis at a local hospital with persistent abdominal distension,abdominal pain,and massive ascites without relief.He was transferred to our hospital,and ascites examination revealed an increase in creatinine.CT urography revealed a local defect in the anterior wall of bladder,spontaneous bladder rupture and pseudo-renal failure were diagnosed.Urination recovered after indwelling a foley catheter,and serum creatinine rapidly decreased to normal.Two weeks later,he was reexamined for healing of the bladder rupture,removal of the catheter,and complete recovery.