Reverse PD—a rare cause of acute renal failure in a transplanted patient

Reverse PD—a rare cause of acute renal failure in a transplanted patient Sir Spontaneous bladder rupture is a known cause of abdominal pain and acute renal failure [1]. Alcoholics and other substance abusers are particularly prone to developing this syndrome [2, 3]. Some patients may present with a history of pelvic surgery, irradiation or a tumor in the lower abdomen [4, 5]. If unrecognized, the mortality of this clinical entity is remarkably high [6]. We report a case of bladder rupture, probably spontaneous, in a young woman who had undergone renal transplantation twice due to congenital cystinosis. Bladder rupture is a pertinent differential diagnosis in transplanted patients with abdominal pain and sudden rise of creatinine. A 29-year-old woman was admitted to our hospital because of acute abdominal pain and anuria. Clinical examination revealed a bloated abdomen with signs of Fig. 1. MRI peritoneography demonstrating irregularity on the bladder dome and large amount of fluid in the peritoneal cavity.