Acute Kidney Injury due to Fish Gallbladder Ingestion: A Case Report from Cambodia

Abstract

We report the case of a 22-year-old woman with a 3-day history of watery stool, generalized abdominal pain, repeated vomiting, and decreased urine output following the consumption of fish gallbladder for self-treatment of acne. She was admitted and received empirical antiemetic, proton pump inhibitor, and intravenous saline treatment. Urine output reduced drastically with markedly elevated urea and creatinine, and she underwent urgent hemodialysis (HD). Based on thorough history taking and prompt biochemical investigations that showed extremely high urea and creatinine levels, we made a diagnosis of acute kidney injury (AKI) secondary to fish gallbladder poisoning. Renal function improved over a period of 5 weeks. Fish gallbladder poisoning is quite frequent in several developing countries in Asia. General physicians in these countries should note that various types of food poisoning can be involved in the etiology of AKI. The condition is commonly reversible, and therefore proper history taking is important and prompt biochemical investigations including blood urea and creatinine are needed to enable early diagnosis and fast institution of treatment, which may include HD.