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A case of urinary ascites with pseudohypoadlosteronism resulting from vesicoureteral junction obstruction

Christopher Joseph Dudek, Douglas R Shapiro, Asad Tolaymat

Abstract


This case illustrates two rare entities occurring concurrently: urinary ascites and pseudohypoadlosteronism secondary to vesicoureteral junction obstruction.  This neonate was prenatally diagnosed with renal agenesis and presented with abdominal distension.   She was found to have gross electrolyte abnormalities and a large amount of ascites by ultrasound.  Paracentesis was performed for drainage of the body fluid, which showed that the fluid was primarily urine by composition and dialysis was performed to correct the electrolyte abnormalities rapidly.  Patient was taken for cystoscopy and reimplantation of the left ureter and drainage of the peritoneal ascites.  After this procedure the aldosterone level normalized and electrolyte levels stabilized, requiring no further interventions for correction.  This paper examines the clinical presentation of urinary ascites and pseudohypoaldosteronism resulting from vesicoureteral junction obstruction, the recent literature guiding treatment of both the cause and underlying abnormalities, and avoidance of this clinical scenario in the future by appropriate work up.


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