Abstract
Acute renal failure due to bilateral ureteral obstruction is a rare complication after appendectomy in children. We report a case of bilateral ureteric obstruction in a 14-year-old boy nine days after surgery for an acute appendicitis. After saline-filling of the urinary bladder, transabdominal ultrasound demonstrated bilateral hydronephrosis of moderate degree. No abscess was found with CT but presence of millimetric stones on both distal ureters was shown, with bilateral calyceal dilatation. Cystoscopy revealed inflammatory changes in the bladder base. Following introduction of bilateral ureteric stents, there was rapid normalisation of urinary output and serum creatinine.
Highlights
IntroductionAppendicitis is still the common cause of emergency abdominal pain and operations in children and adolescents [1]
Appendicitis is still the common cause of emergency abdominal pain and operations in children and adolescents [1].If an unperforated appendix has been removed, postoperative complications occur in only 5% of patients
We report a case of abdominal pain and anuria due to bilateral ureteral obstruction, not related to an abscess, in a 14-year-old boy, several days after appendectomy for acute appendicitis
Summary
Appendicitis is still the common cause of emergency abdominal pain and operations in children and adolescents [1]. If an unperforated appendix has been removed, postoperative complications occur in only 5% of patients. In gangrenous or perforated appendices, occurring in more than one-third of all patients with appendicitis, morbidity rates may be 40% [2]. Well known complications include wound infection, perforation, peritonitis, abscess formation, or mechanical bowel obstruction. Urologic complications are uncommon and usually result from right-sided ureteral obstruction, in most cases due to an appendiceal abscess [3]. Bilateral ureteric obstruction is a rare complication. We report a case of abdominal pain and anuria due to bilateral ureteral obstruction, not related to an abscess, in a 14-year-old boy, several days after appendectomy for acute appendicitis
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