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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Urinary ascites is a rare but clinically significant complication in pediatric patients with urinary tract anomalies. It results from intraperitoneal urine accumulation and leads to severe electrolyte disturbances. Diagnosis is often delayed due to nonspecific symptoms.
We retrospectively reviewed three pediatric cases of urinary ascites, analyzing clinical presentation, laboratory and imaging findings, diagnostic approaches, management strategies, and outcomes.
Three patients (aged 6 months to 11 years) presented with seizures, vomiting, or lethargy. All had underlying urinary tract anomalies: bilateral UVJO post ureteral reimplantation, right MCDK with contralateral UPJO post pyeloplasty, and retroperitoneal fibrosis with bilateral hydronephrosis. Initial labs showed hyponatremia (<110–124 mEq/L), hyperkalemia (4.9–7.8 mEq/L), elevated creatinine (1.15–28.2 mg/dL), and low bicarbonate (7.7–19.2 mEq/L). Serum calcium, phosphate, and magnesium ranged from 6.9–10.2, 5.8–9.5, and 1.7–1.9 mg/dL, respectively.
Renal ultrasound revealed hydronephrosis with ascites in all cases. One postoperative patient showed worsening hydronephrosis and megaureter; another had a sudden decrease in hydronephrosis, suggesting spontaneous rupture. Although an ascitic fluid-to-serum creatinine ratio >1 is typically used to confirm urinary ascites, this criterion was met in only one case, highlighting diagnostic challenges.
All patients were admitted to the PICU and received ascites drainage and urinary decompression via double-J stenting or percutaneous nephrostomy, followed by corrective surgery. Despite severe electrolyte disturbances, all recovered without renal replacement therapy or fatal complications, suggesting early intervention was critical in avoiding irreversible kidney damage.
Over follow-up periods of 6 months to 12 years, one patient with multiple recurrences progressed to stage 3a chronic kidney disease, while the others maintained stable renal function.
Urinary ascites is a rare but potentially fatal complication in pediatric obstructive uropathy or post-urologic surgery. Diagnosis is challenging due to nonspecific signs and variable test results. Early suspicion, imaging, and fluid analysis are vital. Timely drainage and decompression can prevent life-threatening complications and preserve renal function.
