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[Obstructive anuria with non-dilated cavities].

P J Maillet, M Laville, D Pelle-Francoz

    Presse Medicale (Paris, France : 1983)
    |October 5, 1985
    PubMed
    Summary
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    Sudden anuria without urinary tract dilation can mask obstructive causes. Ultrasonography may miss these, but antegrade pyelography confirms blockages, enabling timely percutaneous nephrostomy for recovery.

    Area of Science:

    • Nephrology
    • Radiology
    • Urology

    Background:

    • Obstructive anuria typically presents with hydronephrosis, detectable via ultrasonography.
    • Diagnostic challenges arise when anuria occurs without apparent urinary tract dilation.

    Observation:

    • Four patients presented with anuria despite normal renal function and no initial signs of urinary tract dilation on ultrasonography.
    • Obstacles were only identified days later using ultrasonography-guided antegrade pyelography.

    Findings:

    • Antegrade pyelography successfully identified urinary tract obstructions in cases where ultrasonography initially showed no dilation.
    • Three out of four patients were successfully treated with percutaneous nephrostomy, highlighting the efficacy of this intervention.

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    Implications:

    • These cases challenge the assumption that all urinary tract obstructions cause upstream dilation.
    • Antegrade pyelography is crucial for confirming obstructive anuria when dilation is absent, serving as a primary diagnostic and therapeutic step.
    • Percutaneous techniques, including nephrostomy, offer effective treatment for obstructive anuria.