Intraperitoneal rupture of the urinary bladder can result in elevation of serum BUN and creatinine, both of which are absorbed across the peritoneal surface.
Mechanism: The urinary bladder is usually distended at the time of injury.
Clinical features:
(1) blunt or penetrating trauma to the lower abdomen
(2) unexpected elevation in the serum BUN and creatinine
(3) decreased urine production
(4) abdominal distention with free fluid
Situations where encountered include:
(1) child abuse
(2) seat belt injuries
Differential diagnosis:
(1) acute or chronic renal failure
(2) intraperitoneal hemorrhage (since other organs are often injured, both blood and urine may be present)
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