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[Pyelo-ureteral junction syndrome in a transplanted kidney]
P Héritier1, C Guérin, J Tostain
1Service d'Urologie, Hôpital Nord, CHU Saint-Etienne, Saint-Priez-en-Jarez.
Annales D'Urologie
|January 1, 1990
Summary
A renal transplant patient experienced anuria due to decompensated pyelo-ureteric junction obstruction, despite a normal intravenous pyelogram (IVP) days earlier. This case highlights potential diagnostic challenges in post-transplant urinary obstruction.
Area of Science:
- Nephrology
- Urology
- Transplant Surgery
Background:
- Renal transplantation is a life-saving procedure for end-stage renal disease.
- Post-transplant urinary tract complications can impact graft survival.
- Pyelo-ureteric junction (PUJ) obstruction is a known, albeit uncommon, complication.
Observation:
- A case of a renal transplant recipient presented with anuria on the 27th post-operative day.
- An intravenous pyelogram (IVP) performed on the 22nd day showed no signs of obstruction.
- The patient was diagnosed with decompensated pyelo-ureteric junction obstruction.
Findings:
- Decompensated pyelo-ureteric junction obstruction can occur in renal transplant patients.
- Diagnostic imaging like IVP may not always detect early or intermittent obstruction.
- Anuria can be a late presenting symptom of significant urinary tract compromise.
Implications:
- This case underscores the importance of vigilant monitoring for urinary complications post-renal transplant.
- It suggests that a normal IVP does not entirely rule out the possibility of PUJ obstruction.
- Further investigation may be warranted in cases of unexplained anuria, even with prior normal imaging.