Differential Diagnosis for Urinary Retention and Ascites, Ureter Rupture
- Single Most Likely Diagnosis
- Post-Renal Acute Kidney Injury (Obstructive Uropathy): This condition is likely due to the obstruction of urine flow, which can cause urinary retention and potentially lead to ascites if the obstruction is severe and bilateral, affecting kidney function. Ureter rupture could be a consequence of the obstruction or an independent cause leading to similar symptoms.
- Other Likely Diagnoses
- Bladder Outlet Obstruction: Conditions such as benign prostatic hyperplasia (BPH), bladder stones, or tumors could cause urinary retention. If severe, this could lead to secondary complications like hydronephrosis and potentially ascites due to renal failure.
- Ureteral Obstruction: Similar to post-renal AKI, obstruction at the level of the ureters (due to stones, tumors, or other causes) could lead to urinary retention and ascites if both ureters are affected, impairing renal function.
- Abdominal Cancer: Certain abdominal cancers, especially those involving the pelvic area, can cause ureteral obstruction leading to urinary retention and ascites due to tumor spread or metastasis.
- Do Not Miss Diagnoses
- Ruptured Abdominal Aortic Aneurysm (AAA): Although less directly related to urinary symptoms, a ruptured AAA can cause abdominal pain, hypotension, and potentially ascites. The proximity of the aorta to the ureters could theoretically cause ureteral rupture or obstruction due to the hematoma.
- Sepsis: Infection leading to sepsis could cause or exacerbate symptoms of urinary retention and ascites, especially if the source of infection is related to the urinary tract.
- Rare Diagnoses
- Retroperitoneal Fibrosis: A rare condition characterized by the proliferation of fibrous tissue in the retroperitoneum, which can encase and obstruct the ureters, leading to urinary retention and potentially ascites.
- Lymphoma: Certain types of lymphoma can cause ureteral obstruction due to lymph node enlargement in the retroperitoneum, leading to the symptoms described.
- Congenital Anomalies: In rare cases, congenital anomalies of the urinary tract could lead to obstruction and the described symptoms, although these would typically be identified earlier in life.