Chonnam Med J.  2013 Aug;49(2):87-90. 10.4068/cmj.2013.49.2.87.

Pseudomyxoma Peritonei: A Rare Cause of Oliguric Acute Kidney Injury

• Min HS
• Pyo JH
• Moon ES
• Choi J
• Kang YS
• Lee MJ
• Cha JJ
• Cha DR

• KMID: 1428268
• DOI: http://doi.org/10.4068/cmj.2013.49.2.87

Abstract

Pseudomyxoma peritonei is a rare clinical condition that causes the accumulation of mucinous ascites, which gradually results in the compression of intra-abdominal organs. Most published reports of pseudomyxoma peritonei concern the mass effect of the resulting ascites, which presents as abdominal pain or intestinal ileus in severe cases. However, few reports of renal complications of the disease have been published. Here, we present a case of oliguric acute kidney injury caused by external compression by pseudomyxoma peritonei. After decompression with external drainage, the patient's renal function rapidly improved.

Keyword

Acute kidney injury; Oliguria; Pseudomyxoma peritonei

MeSH Terms

Abdominal Pain
Acute Kidney Injury
Ascites
Decompression
Drainage
Ileus
Mucins
Oliguria
Pseudomyxoma Peritonei
Mucins

Figure

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  FIG. 1 Abdominal computed tomography (CT) imaging. CT scan showing right hydronephrosis and hydroureter associated with massive ascites before (A) and after (B) right percutaneous nephrostomy and abdominal pigtail catheter insertion.

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  FIG. 2 The patient's urine output and renal function recovered after pigtail drainage. PCN: percutaneous nephrostomy.

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  FIG. 3 Histopathology of mucinous implants and neoplastic cells from the cystic wall and peritoneum of the ascending colon. (A) Hematoxylin and eosin (H&E) ×100. (B) Immunohistochemistry for cytokeratin 20 (CK20). Peritoneal lesions were composed of abundant extracellular mucin lining with simple or focally proliferative mucinous epithelium with little cytologic atypia or mitotic activity. In immunohistochemistry for CK20, immunoreactivity for CK20 was strong in the cytoplasm in neoplastic cells, which suggested the lower gastrointestinal tract as the origin.

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