Urinary bladder rupture years after excision of urachal remnant

A 13-year-old boy presented with acute kidney injury, abdominal discomfort, and distention secondary to urinary ascites. He had undergone a robotic-assisted laparoscopic excision of a urachal cyst 5 years prior to presentation. Further examination revealed decreased urine output, elevated serum creatinine, and hyperkalemia. He was diagnosed with rapidly progressive glomerulonephritis requiring hemodialysis. Further investigation of ascites fluid demonstrated significantly elevated creatinine consistent with urine. A computed tomography cystogram demonstrated an intraperitoneal bladder rupture. He underwent an emergent surgical cystorrhaphy with significant improvement.