Urinary ascites in a neonate with posterior urethral valve

Authors

  • Syed M. Qurram Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India
  • C. V. S. Lakshmi PDepartment of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India http://orcid.org/0000-0002-6412-5385
  • Farhana Nazneen Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India
  • Mohammed U. Khan Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212062

Keywords:

Urinary ascites, Newborn, Male, Posterior Urethral valves

Abstract

Urinary ascites in a newborn is an extremely rare condition, most commonly due to posterior urethral valves, due to transmission of high intravesical pressure to calyceal fornices, and subsequent urinary ascites either by calyceal perforation or filtration through walls of urinary tract and their rupture. We describe a newborn male baby, who presented with huge abdominal distension at birth, and diagnosed as urinary ascites on paracentesis. Baby was asphyxiated and required resuscitation at birth, and ventilatory support for 4 days in v/o significant abdominal distension. Micturating cystourethrogram (MCUG) and magnetic resonance imaging (MRI) showed posterior urethral valves. Baby also had a left sided urinoma and grade 4 vesicoureteral reflux (VUR) on MCUG. Post paracentesis and drainage of 400ml of ascetic fluid, and urinary catheterization, baby had significant improvement of deranged renal parameters, and diuresis, and could be weaned from ventilation. In v/o inability to negotiate a urethroscope, a vesicostomy was done for urinary drainage and fulguration of valves planned on follow-up.

Author Biographies

Syed M. Qurram, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India

Resident,

C. V. S. Lakshmi, PDepartment of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India

Chief Consultant Neonatologist and Assistant Professor of Pediatrics,

Farhana Nazneen, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India

Resident,

Mohammed U. Khan, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India

Resident, Department of Pediatrics

References

Mauriceau F, Grosses T, Lauteur C. Paris, France, 3rd edition. 1681.

Cywes SJ, Wynne JM, Louw JH. Urinary ascites in the new-born with a report of two cases. J Pediatr Surg. 1968;3(3):350-6.

James U, Davies JA. Congenital urethral obstruction presenting in the newborn period. Proceedings of the Royal Soc Med. 1952;45:401.

Singh J, Khanna AC, Arora S. A rare case of urinary ascites in newborn. Int J Med Dent Sci. 2016;5(1):1098-100.

Ahmed S, Borghol M, Hugosson C. Urinoma and urinary ascites secondary to calyceal perforation in neonatal posterior urethral valves. Br J Urol. 1997;79:991-2.

Trulock TS, Finnerty DP, Woodard JR. Neonatal bladder rupture: case report and review of literature. J Urol. 1985;133(2):271-3.

Griscom NT, Colodny AH. Diagnostic aspects of neonatal ascites: report of 27cases. Am J Roentgenol. 1977;128:961-9.

Malin G, Tonks AM, Morris RK, Gardosi J, Kilby MD. Congenital lower urinary tract obstruction: a population-based epidemiological study. BJOG. 2012;119(12):1455-64.

Farhat W, McLorie G, Capolicchio G, Khoury A, Bägli D, Merguerian PA. Outcomes of primary valve ablation versus urinary tract diversion in patients with posterior urethral valves. Urol. 2000;56(4):653-7.

Downloads

Published

2021-05-25

Issue

Section

Case Reports