Bilateral Ureteral Obstruction in Children after Appendectomy

Area of Science:

• Pediatric Surgery
• Nephrology
• Urology

Background:

• Appendectomy is a common pediatric surgical procedure.
• Acute renal failure secondary to bilateral ureteral obstruction is a rare but serious complication.
• Post-appendectomy complications require prompt diagnosis and management.

Purpose of the Study:

• To report a rare case of bilateral ureteral obstruction following appendectomy in a child.
• To highlight the diagnostic challenges and successful management of this complication.
• To emphasize the importance of considering urinary tract complications after abdominal surgery.

Main Methods:

• Case report of a 14-year-old boy.
• Diagnostic workup included transabdominal ultrasound and CT scan.
• Cystoscopy was performed to evaluate bladder and ureteral openings.
• Management involved bilateral ureteric stent placement.

Main Results:

• The patient presented with acute renal failure nine days post-appendectomy.
• Imaging revealed bilateral hydronephrosis, distal ureteral stones, and calyceal dilatation.
• Cystoscopy showed inflammatory changes in the bladder base.
• Ureteric stenting led to rapid normalization of urinary output and serum creatinine.

Conclusions:

• Bilateral ureteral obstruction is a rare but significant complication after appendectomy in children.
• Early diagnosis and intervention with ureteric stenting can effectively manage this condition.
• This case underscores the need for vigilance regarding urinary tract complications post-appendectomy.