気腫性膀胱炎による膀胱破裂から偽性腎不全を呈した1症例

Pseudo-renal Failure due to Urinary Bladder Rupture with Emphysematous Cystitis：A Case Report

要旨

　意識障害を認めた69歳の男性に，著明な炎症反応の上昇と急性腎不全，高カリウム血症，異常高血糖，腹腔内と膀胱壁内に遊離ガスを認めた。緊急手術となり，膀胱破裂であった。腎機能低下は，膀胱破裂による偽性腎不全であった。膀胱破裂においては，偽性腎不全の可能性を念頭に置くべきである。

　Here, we report a case of pseudo-renal failure due to emphysematous cystitis.

　A 68-year-old man presented with fever and abdominal pain. Emergency laparotomy revealed a bladder rupture. He had hyperkalemia and acute renal failure. Initially, we suspected as exacerbation of renal function due to septic or diabetic nephropathy. However, the bladder rupture was considered to have resulted from peritonitis and pseudo-renal failure, because the serum laboratory findings indicated acute kidney injury and improved more rapidly compared to usual postoperative findings.

　When urinary bladder rupture with acute kidney injury is suspected, pseudo-renal failure should be considered.