Indian Journal of Critical Care Case Report

Register      Login

VOLUME 1 , ISSUE 3 ( November-December, 2022 ) > List of Articles

CASE REPORT

Deep Buried Cause of Anuria in a Patient Admitted after Elective Prolonged Surgery in a Syndromic Patient

Kuldeep S Sindhlian, Zia Arshad, Gyan P Singh

Keywords : Anuria, Digital subtraction angiography, Iatrogenic, Retrograde pyelogram

Citation Information : Sindhlian KS, Arshad Z, Singh GP. Deep Buried Cause of Anuria in a Patient Admitted after Elective Prolonged Surgery in a Syndromic Patient. 2022; 1 (3):73-74.

DOI: 10.5005/jp-journals-11006-0024

License: CC BY-NC 4.0

Published Online: 02-01-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background and clinical case: Acute kidney injury (AKI) with anuria is a common occurrence in intensive care unit (ICU) patients and is also among the common reason for ICU admission in the postoperative period with multiple etiologies. Iatrogenic tying of the ureter during surgery while resection is rare but a significant cause of unexplained anuria during hysterectomy. Delayed diagnosis results in more severe clinical sequelae and unfavorable legal outcomes. Isolated anuria with stable hemodynamics and acceptable arterial blood gas (ABG) parameters should raise suspicion of iatrogenic anuria. This article aims to outline the clinical course and management of a syndromic patient with multiple challenges who presented with anuria, later the cause of which was found to be iatrogenic tying of the ureter during surgery. The diagnosis of this rare occurrence warrants vigilance, early detection, and prompt management. Conclusion: A multidisciplinary team approach and early use of available imaging modalities like ultrasonography (USG), digital subtraction angiography (DSA), and retrograde pyelogram (RPG) help in the identification and management, thus reducing morbidity and mortality.


HTML PDF Share
  1. Lee RA, Symmonds RE, Williams TJ. Current status of genitourinary fistula. Obstet Gynecol 1988;72(3 Pt 1):313–319. PMID: 3043287.
  2. Dowling RA, Corriere JN Jr, Sandler CM. Iatrogenic ureteral injury. J Urol 1986;135(5):912–915. DOI: 10.1016/s0022-5347(17)45921-0
  3. St Lezin MA, Stoller ML. Surgical ureteral injuries. Urology 1991;38(6):497–506. DOI: 10.1016/0090-4295(91)80165-4
  4. Grainger DA, Soderstrom RM, Schiff SF, et al. Ureteral injuries at laparoscopy: insights into diagnosis, management, and prevention. Obstet Gynecol 1990;75(5):839–843. DOI: 10.1016/0020-7292(90)90558-3
  5. Ravikanth R, Majumdar P. Complete Müllerian agenesis, renal agenesis, and renal ectopia: MURCS association – a rare cause of primary amenorrhea. Apollo Med 2019;16(4):250–251. DOI: 10.4103/am.am_56_19
  6. Abboudi H, Ahmed K, Normahani P, et al. Decision making in urological surgery. Int Urol Nephrol 2012;44(3):701–710. DOI: 10.1007/s11255-011-0101-0
  7. Burks FN, Santucci RA. Management of iatrogenic ureteral injury. Ther Adv Urol 2014;6(3):115–124. DOI: 10.1177/1756287214526767
  8. Ravlo M, Moen MH, Bukholm IRK, et al. Ureteric injuries during hysterectomy-a Norwegian retrospective study of occurrence and claims for compensation over an 11-year period. Acta Obstet Gynecol Scand 2022;101(1):68–76. DOI: 10.1111/aogs.14293
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.