Obstructive uropathy, renal failure, and sepsis in the neonate--a surgical emergency

Two infants who had obstructive uropathy accompanied by renal failure and sepsis are reported herein. Diagnostic and therapeutic techniques used to treat this type of surgical emergency are discussed in the order they were performed, as follows: (1) resuscitation for severe fluid and electrolyte disturbances; (2) gathering of cultures and initiation of antibiotic therapy; (3) the decision of whether or not dialysis is required, as well as when and how diagnostic evaluation should proceed; (4) the decision of whether dialysis is necessary or whether correction of obstructive uropathy can begin; and (5) the choice of the best operative procedure for this individual. This article emphasizes the necessity for a multidisciplinary team approach to these patients.