Anuric, obstructive uropathy in the absence of obvious radiological evidence of obstruction

Leong, Wing Seng; Sells, Henry; Moretti, Kim

doi:10.1111/j.1445-2197.2004.03001.x

Cited by 2 publications

(2 citation statements)

References 25 publications

(32 reference statements)

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“…A further two cases of non-dilated obstructive uropathy occurring on a background of malignancy are presented by Onuigbo et al ,21 the first being a 56-year-old man who was eventually diagnosed with a urothelial carcinoma and the second, a 59-year-old woman with a history metastatic uterine cervical adenocarcinoma. Leong et al 22 presented a case in a 31-year-old man with a history of ulcerative colitis, who presented in a similar way to the case presented here, with flank pain, dehydration and sepsis. The lack of dilation in these cases may be due to hypovolaemia, oedema, retroperitoneal metastases, retroperitoneal fibrosis or a retroperitoneal tumour 19–22.…”

Section: Discussionsupporting

confidence: 63%

Pyelonephritis and obstructive uropathy: a case of acute kidney injury

Ashmore

Thompson

2016

BMJ Case Reports

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We present a case of a man in his late 50s with a history of metastatic prostate carcinoma requiring bilateral ureteric stenting. He was admitted with increasing confusion and lethargy. He was diagnosed with sepsis and an acute kidney injury (AKI). Clinical suspicions of an obstructive component to his AKI were not confirmed by an ultrasound scan, which showed a unilateral hydronephrosis unchanged from a scan 1 month previously. A nephrostomy was performed, and frank pus aspirated. The patient's clinical state improved steadily thereafter. Patients who are dehydrated, or who have suffered from malignant or fibrotic processes affecting the retroperitoneum, may present with urinary obstruction without a corresponding increase in urinary tract dilation. Additionally, there must be a suspicion of pyonephrosis in a symptomatic patient with known hydronephrosis. Clinicians should be aware that clinical suspicions of urinary obstruction not demonstrated on ultrasound scanning require further investigation.

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Section: Discussionsupporting

confidence: 63%

Pyelonephritis and obstructive uropathy: a case of acute kidney injury

Ashmore

Thompson

2016

BMJ Case Reports

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“…Approximately 4% of patients with obstructive renal failure have minimal or no dilatation of the renal pelvis (14). Bilateral ureteric obstruction with external compression caused by retroperitoneal fibrosis or malignant disease accounts for 60% of these cases (2,10,11,17,18). At most centers, the procedure is performed under fluoroscopic guidance, for which the pelvicalyceal system is opacified either by intravenous administration of contrast material or by performing an initial thin-needle (22 or 23 gauge) antegrade pyelography (19).…”

Section: Discussionmentioning

confidence: 99%