Seyed Majid Mousavi Movahhed
1, Leila Sabetnia
2, Mohammad Javad Alemzadeh-Ansari
3, Shahla Ahmadi Halili
2*, Seyed Seifollah Beladi Mousavi
21 Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
2 Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Control of intake and urinary output is an important measure in the management of patients
with acute renal failure (ARF) and non-correct recordation of urinary output by nurses may
cause a severe problem in the management of these patients. The reported case was a 34-yaer-old
woman who developed ARF and anuria after hysterectomy during emergency cesarean section.
Computed tomography and serial ultrasonography of kidneys and urinary tract revealed mild
hydronephrosis. Although, our patient had anuria, but recoded urinary output by nurses was
300-350 mL/d because urinary bag has not been emptied at the end of each day. Therefore, we
thought that ARF is due to acute tubular necrosis because of severe bleeding during cesarean
section. We also interpreted that hydronephrosis is secondary to recent pregnancy. After
10 days, it was detected that the patient has not been any urinary output during this period.
Therefore the diagnosis was changed to urinary obstruction because of bilateral ureteral ligation
during hysterectomy.
Implication for health policy/practice/research/medical education:
In an approach to a patient with anuria after pelvic operations, urinary tract obstruction must be reminded. Early diagnosing
and resolving obstruction may lead to completely return of renal function. However, if neglected, it can lead to non-compensative
complications.
Please cite this paper as: Mousavi Movahhed SM, Sabetnia L, Alemzadeh-Ansari MJ, Ahmadi Halili S, Beladi Mousavi SS. A
minor fault may lead to a major complication J Renal Inj Prev. 2018;7(3):116-118. doi: 10.15171/jrip.2018.27.