In assessment of pediatric emergencies, failure to consider the possibility of child abuse may result in delayed initiation of appropriate diagnostic procedures or definitive treatment. This report concerns a 6-year-old boy with acute renal failure resulting from a ruptured bladder, to our knowledge a previously undescribed manifestation of child abuse.
Report of a Case.—A 6-year-old boy was admitted to the University of California, Davis Medical Center in Sacramento because of elevated levels of serum potassium and BUN. During the preceding five days, a complaint of abdominal pain and constipation was followed by intermittent vomiting, a noticeable decrease in urine output, several episodes of gross hematuria and hematochezia, and a progressive deterioration of mental status to the point of noticeable lethargy and confusion. Except for a fall in the shower, there was no history of trauma or of upper respiratory infection, joint symptoms, rash, or exposure to drugs or toxins.
HALSTED CC, SHAPIRO SR. Child Abuse: Acute Renal Failure From Ruptured Bladder. Am J Dis Child. 1979;133(8):861–862. doi:10.1001/archpedi.1979.02130080101025
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