scholarly journals A vesico-peritoneal fistula in a patient with history of diverticulitis-related colovesical fistula repair: a case report

2020 ◽  
Vol 7 (9) ◽  
pp. 3086
Author(s):  
Alberto Riojas Garza ◽  
José Ignacio Ortiz De Elguea Lizárraga ◽  
Giovanna Arteaga Müller ◽  
Miguel A. Orozco Saldivar ◽  
Luis E. Salgado Cruz
Keyword(s):  
Renal Failure ◽  
Abdominal Pain ◽  
Serum Creatinine ◽  
Primary Closure ◽  
Fistulous Tract ◽  
Elevated Serum ◽  
Chronic Abdominal Pain ◽  
Colovesical Fistula ◽  
Elevated Serum Creatinine ◽  
History Of

A vesico-peritoneal fistula is an epithelialized communication between the peritoneal cavity and the urinary bladder. It is a rare entity scarcely reported in medical literature. High index of suspicion is needed for diagnosis and treatment. Here we expose the case of a vesico-peritoneal fistula presenting with chronic abdominal pain 4 years after sigmoidectomy. A 38-year-old male presented with lower quadrant abdominal pain. He had history of sigmoidectomy with colorectal anastomosis and bladder repair due to diverticular disease-related colovesical fistula 5 years prior to admission. Elevated serum creatinine levels and oliguria were documented. Intraperitoneal free fluid was found by computed tomography (CT) scan. Percutaneous drainage was performed, and laboratory test showed elevated peritoneal creatinine levels. CT-Cystography revealed a vesico-peritoneal fistula. Dissection of fistulous tract and primary closure of bladder defect was achieved. Vesico-peritoneal fistulas have been described as surgical procedure complications with a variable postoperative time of presentation. Low index of suspicion led to delayed diagnosis, finally suspected by intraperitoneal fluid analysis and confirmed by cystography. Intraperitoneal reabsorption of urine elevated serum creatinine levels mimicking renal failure. Management ranges from conservative to surgical procedures, in this case fistulous tract dissection and primary bladder closure was accomplished. Vesico-peritoneal fistulas are rarely reported. Common clinical findings include chronic abdominal pain and free intraperitoneal fluid. Misdiagnosis of acute renal failure is frequent due to elevated serum creatinine levels and oliguria.  Laparoscopic dissection of fistulous tract and primary closure of bladder defect is a safe option as treatment of this condition.

scholarly journals Renal Failure and Hepatitis Following Ingestion of Raw Grass Carp Gallbladder: A Case Report

2020 ◽  
Author(s):  
Lina Zhou ◽  
Shaoshao Dong ◽  
Shengze Zhang ◽  
Wen Huang
Keyword(s):  
Renal Failure ◽  
Serum Creatinine ◽  
Grass Carp ◽  
Elevated Serum ◽  
Food Poisoning ◽  
Organ Damage ◽  
The People ◽  
Folk Remedy ◽  
History Of

Abstract Background: Fish gallbladder has long been used as folk remedy in Asian countries.Multiple organ damage after fish gallbladder ingestion resulting in near mortality has been known to occur.Here,we describe a case of grass carp gallbladder poisoning and review the literature.Case Presentation: A previously healthy, 50-year-old woman was admitted to our hospital with a 2-day history of generalized abdominal pain and repeated vomiting following ingestion of 2 raw, grass carp gallbladders in an attempt to alleviate her cough. She developed anuria on day 4 with markedly elevated serum creatinine, urea, bilirubin, alanineaminotransferase, and aspartate aminotransferase.Based on thorough evaluation of her history and prompt biochemical investigations, we diagnosed her with acute renal failure and hepatitis secondary to fish gallbladder poisoning.Her renal biopsy revealed acute tubular necrosis.And she underwent six sessions of conventional hemodialysis due to renal failure. Supportive treatment, like gastric mucosal protectant and liver protectant were administered for targeted organ protection.The patient’s liver function gradually recovered and serum creatinine was 164 ummol/l at discharge on day 24. Over a period of 2-week follow-up, her renal function completely recovered. Conclusion: The purpose of this paper is to highlight the need for physicians to be mindful of the toxic complications of raw grass carp gallbladder ingestion and to promote its awareness among the people to help reduce this incidence of food poisoning.

scholarly journals A Healthy Active Duty Soldier with an Elevated Serum Creatinine

2021 ◽  
Author(s):  
Trevor W Tobin ◽  
John S Thurlow ◽  
Christina M Yuan
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Renal Injury ◽  
Elevated Serum ◽  
Active Duty ◽  
Medical Problems ◽  
Sports Supplements ◽  
Elevated Serum Creatinine ◽  
Elevated Creatinine

ABSTRACT Creatine products and sports supplements are widely used by active duty soldiers. These products are associated with both acute renal failure and elevated serum creatinine levels without renal injury. We present a case involving an active duty, 26-year-old Caucasian soldier who was evaluated in our clinic for elevated creatinine levels. This patient had no active medical problems and was noted on repeat labs to have significantly elevated creatinine levels. Subsequent investigations led us to conclude these values were not associated with renal injury and were due to ingested supplements.

scholarly journals Elevated Serum Creatinine: But Is It Renal Failure?

PEDIATRICS ◽  
2020 ◽  
Vol 146 (1) ◽  
pp. e20192828
Author(s):  
Molly Wong Vega ◽  
Sarah J. Swartz ◽  
Sridevi Devaraj ◽  
Srivaths Poyyapakkam
Keyword(s):  
Renal Failure ◽  
Serum Creatinine ◽  
Elevated Serum ◽  
Elevated Serum Creatinine

Falsely elevated serum creatinine concentration in ketoacidosis

1985 ◽  
Vol 107 (4) ◽  
pp. 562-564 ◽  
Author(s):  
Farahnak K. Assadi ◽  
Eunice G. John ◽  
Linda Fornell ◽  
Ira M. Rosenthal
Keyword(s):  
Serum Creatinine ◽  
Elevated Serum ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration ◽  
Elevated Serum Creatinine

scholarly journals VURD Syndrome Managed by Pyelostomy

2004 ◽  
Vol 4 ◽  
pp. 382-386
Author(s):  
Charles J. Rosser ◽  
Sam Auringer ◽  
R. L. Kroovand
Keyword(s):  
Serum Creatinine ◽  
Vesicoureteral Reflux ◽  
Urinary Diversion ◽  
Elevated Serum ◽  
Prenatal Ultrasound ◽  
Elevated Serum Creatinine ◽  
Elevated Creatinine ◽  
Cutaneous Vesicostomy

We report a case of VURD syndrome in a three day old neonate who was diagnosed with hydronephrosis on a prenatal ultrasound. Severe tortuosity and dilation of the upper urinary tracts in the presence of progression of hydronephrosis or a persistently elevated creatinine may favor a proximal urinary diversion rather than primary valve ablation or cutaneous vesicostomy. Because of a persistently elevated serum creatinine, a nonfunctioning kidney with grade 4/5 vesicoureteral reflux and worsening contralateral hydronephrosis despite lower tract drainage, a left cutaneous pyelostomy was performed, contralateral to the kidney involved with VURD. Postoperatively the serum creatinine stabilized at 1.0 mg/dl and decreased to 0.3 mg/dl at one month of age.

The Impact of Renal Impairment on the Management of Patients with Lower Urinary Tract Obstruction

1997 ◽  
Vol 27 (2) ◽  
pp. 75-77 ◽  
Author(s):  
B C Ogbonna ◽  
A G Madziga ◽  
E A Anteyi
Keyword(s):  
Urinary Tract ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Elevated Serum ◽  
Elevated Serum Creatinine ◽  
Urethral Strictures ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

One hundred patients with lower urinary tract obstruction (LUTO) seen over a 10-month period were prospectively studied. Nineteen (19%) had an elevated serum creatinine (>125 μmol/l); 13% had benign prostatic hyperplasia (BPH); 4% had urethral strictures; and two had congenital anomalies. Though urethral strictures are more common than BPH they cause less renal impairment, probably because the patients are younger and also because a urinary fistula may form proximal to the stricture when the intravesical pressure rises very high. Eighty per cent of the patients with renal impairment had a urinary tract infection (UTI), and in these the reduction in serum creatinine following relief of obstruction was slow and erratic. In three patients who did not have UTI the serum creatinine dropped steadily at a rate which varied from 6.8–845 μmol/l/week following continuous bladder drainage and appropriate supportive management. All patients with elevated serum creatinine had delayed surgery and required prolonged preoperative hospitalization, with a resultant sharp increase in the cost of their treatment.

Acute Kidney Injury in Children with Severe Malaria Is Common and Associated with Adverse Hospital Outcomes

2019 ◽  
Vol 66 (2) ◽  
pp. 218-225
Author(s):  
Eunice O Oshomah-Bello ◽  
Christopher I Esezobor ◽  
Adaobi U Solarin ◽  
Fidelis O Njokanma
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Severe Malaria ◽  
Complete Blood Count ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
Kidney Injury ◽  
Hospital Outcomes ◽  
Elevated Serum Creatinine ◽  
Sub Saharan

Abstract Background The prevalence of acute kidney injury (AKI) in children with severe malaria in sub-Saharan African may have been underestimated. The study aimed to determine the prevalence of AKI in children with severe malaria and its association with adverse hospital outcomes. Methods At presentation, we measured complete blood count, serum bilirubin, and serum electrolytes, urea and creatinine in children with severe malaria. At 24 h after hospitalization, we repeated serum creatinine measurement. Urine passed in the first 24 h of hospitalization was also measured. We defined AKI and its severity using the Kidney Disease: Improving Global Outcome AKI guidelines. Results The study involved 244 children (53.3% males) with a median age of 3.5 (1.9–7.0) years. One hundred and forty-four (59%) children had AKI, and it reached maximum Stages 1, 2 and 3 in 56 (23%), 45 (18.4%) and 43 (17.6%) children, respectively. The majority (86.1%) with AKI had only elevated serum creatinine. Mortality increased with increasing severity of AKI on univariate analysis but weakened on multiple logistic regression. Mortality was also higher in those with both oliguria and elevated serum creatinine than in those with elevated serum creatinine only (50% vs. 4.8%, p < 0.001). Furthermore, children with AKI spent three days more in hospital than those without AKI (p < 0.001). Conclusions Acute kidney injury complicates severe malaria in 6 out of every 10 children and is commonly identified using elevated serum creatinine. It is also associated with adverse hospital outcome.

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