Case submitted by dr Arwa,

 

Delayed presentation , 3 month old bladder exstrophy , with small bladder plate.

 

primary repair & post osteotomy was performed, but pt developed generalized oedema ,& severe ascites on the 6th day post op , not responding to fluid restrictions or Human albumin.

 

 

How to manage

 

Does the patient pass urine adequately ?

did you did urea and creatinine from ascitis fluid ?

what about renal function and renal us ?

Please consider urinary ascites as first possibility.

Thank you for your replies, as urinary ascites was excluded

we sent urine albumin/ creatinine ratio & pt was diagnosed with congenital nephrotic syndrome .