{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T13:21:34Z","timestamp":1775827294445,"version":"3.50.1"},"reference-count":9,"publisher":"SMC Media","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction:\u00a0Urinary ascites secondary to spontaneous rupture of the urinary bladder (SRUB) is a rare clinical entity presenting with non-specific symptoms, which poses a significant diagnostic challenge. A specific presentation involves pseudo-renal failure because of peritoneal reabsorption of urinary solutes. Case description:\u00a0We present the case of a female in her sixties with recurrent severe abdominal pain and ascites, concomitated with apparent acute kidney injury. Her medical history was significant for Wertheim-Meigs hysterectomy and pelvic radiation for cervical cancer. She underwent multiple hospitalisations with extensive investigations and even exploratory surgeries, driven by misleading CT findings of diffuse bowel wall thickening and gross ascites. The definitive diagnosis was made by extensive review of the patients\u2019 medical records and research of similar cases in the literature, as also by paracentesis, revealing an ascites-to-serum creatinine ratio of 3.76. A computed tomography cystogram confirmed an intraperitoneal bladder rupture with contrast extravasation. The patient was successfully managed conservatively with intermittent self-catheterisation. Conclusion:\u00a0In patients with urogenital comorbidities developing large-volume ascites without preceding trauma, urinary ascites should be considered an important differential diagnosis, typically defined by an ascites-to-serum creatinine ratio of &gt;1. This case explores the diagnostic pitfalls of urinary ascites secondary to SRUB in a patient with late radiation cystitis focusing on the phenomenon of reverse auto peritoneal dialysis and a normal cystatin C level as key diagnostic clues.<\/jats:p>","DOI":"10.12890\/2026_006293","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:30:55Z","timestamp":1774942255000},"source":"Crossref","is-referenced-by-count":0,"title":["Urinary ascites secondary to recurrent spontaneous bladder rupture mimicking renal failure: a diagnostic odyssey in a post-radiation patient"],"prefix":"10.12890","volume":"13","author":[{"given":"Bettina","family":"Schreiber","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cantonal Hospital of Grisons, Chur, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Hosek","sequence":"first","affiliation":[{"name":"Department of Nephrology\/Dialysis, Cantonal Hospital of Grisons, Chur, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Burgener","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cantonal Hospital of Grisons, Chur, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"10.12890\/2026_006293_ref1","doi-asserted-by":"crossref","unstructured":"Reddy D, Laher AE, Lawrentschuk N, Adam A. Spontaneous (idiopathic) rupture of the urinary bladder: a systematic review of case series and reports. BJU Int 2023;131:660-674. doi: 10.1111\/bju.15974","DOI":"10.1111\/bju.15974"},{"key":"10.12890\/2026_006293_ref2","doi-asserted-by":"crossref","unstructured":"Chennu KK, Rapur R, Vishnubotla SK. Reverse autoperitoneal dialysis resulting in pseudo acute renal failure. Clin Kidney J 2013;6:551. doi: 10.1093\/ckj\/sft093","DOI":"10.1093\/ckj\/sft093"},{"key":"10.12890\/2026_006293_ref3","unstructured":"Mayo Clinic. Bladder stones. Rochester (MN); Foundation for Medical Education and Research; [updated 30 October 2025; cited 18 January 2026]. Available from: https:\/\/www.mayoclinic.org\/diseases-conditions\/bladder-stones\/symptoms-causes\/syc-20354339"},{"key":"10.12890\/2026_006293_ref4","doi-asserted-by":"crossref","unstructured":"Jing H, Xiuhong W, Ying Y, Xiyun C, Deping L, Changmei S, et al. Complications of radical hysterectomy with pelvic lymph node dissection for cervical cancer: a 10-year single-centre clinical observational study. BMC Cancer 2022;22:1286. doi: 10.1186\/s12885-022-10395-9","DOI":"10.1186\/s12885-022-10395-9"},{"key":"10.12890\/2026_006293_ref5","doi-asserted-by":"crossref","unstructured":"Ono K, Matsumoto H, Komagata Y. Acute kidney injury and ascites in a patient with a history of cervical cancer. Kidney360 2024;5:1226\u20131227. doi: 10.34067\/KID.0000000000000500","DOI":"10.34067\/KID.0000000000000500"},{"key":"10.12890\/2026_006293_ref6","doi-asserted-by":"crossref","unstructured":"Uchida K, Gotoh A. Measurement of cystatin-C and creatinine in urine. Clin Chim Acta 2002;323:121\u2013128. doi: 10.1016\/s0009-8981(02)00177-8","DOI":"10.1016\/S0009-8981(02)00177-8"},{"key":"10.12890\/2026_006293_ref7","unstructured":"Biggins, S.W. Evaluation of adults with ascites. In: UpToDate [updated 20 September 2024, cited 18 January 2026] [Internet]. Available from: https:\/\/www.uptodate.com\/contents\/evaluation-of-adults-with-ascites"},{"key":"10.12890\/2026_006293_ref8","doi-asserted-by":"crossref","unstructured":"Ramchal TD, Wegermann K, Wolf A. Not all ascites is created equal: a rare case of urinary ascites masquerading as a high serum-ascites albumin gradient (SAAG), low protein fluid. Am J Gastroenterol 2020;115:S1279\u2013S1280. doi: 10.14309\/01.ajg.0000711696.07004.ff","DOI":"10.14309\/01.ajg.0000711696.07004.ff"},{"key":"10.12890\/2026_006293_ref9","doi-asserted-by":"crossref","unstructured":"Ridinger HA, Kavitt RT, Green JK. Urinary ascites and renal failure from unrecognized bladder rupture. AM J Med 2012;125:e1\u2013e2. doi: 10.1016\/j.amjmed.2012.01.019","DOI":"10.1016\/j.amjmed.2012.01.019"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6293\/5351","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6293\/5352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6293\/5352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T12:10:24Z","timestamp":1775823024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/6293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.12890\/2026_006293","relation":{"has-manifestation":[{"id-type":"other","id":"1-166-6293-g5351","asserted-by":"subject"},{"id-type":"other","id":"1-166-6293-g5352","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-166","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}