Foley catheter: in bladder, but there is no urine in the bladder.
Drain: somewhere in abdomen, but draining a fluid with same [Creatinine] as the serum. If the concentration is the same, it is not urine but probably just serum?
So there is no urine in the bladder, no urine in the abdomen, and there is bilateral hydronephrosis.
=> Both ureters ligated by accident due to Dr. LowYieldSurgeon.
Young woman with recent total abdominal hysterectomy who is anuric with drain creatinine = serum creatinine, AKI and mild bilateral hydronephrosis consistent with ureteral ligation/damage due to surgery
Key idea: Drain fluid creatinine: Serum creatinine ratio > 1 consistent with urine leak
Key idea: Hysterectomy and other female GU operations are highly associated with ureteral damage (especially in NBME exams)
seagullWhy does she still have hydronephrosis bilaterally? Why doesn't the drain collect more urine if it's ligation (draining urine into the peritoneum)? Why would both be injured - WTF is this blind surgeon doing?+10
etherbunnyLigation means that they tied the ureters off, rather than cut them. So they don't leak adn instead urine builds up in the ureter causing hydronephrosis.
...and indeed, WTF was the surgeon doing?+1
satanicdo"severe endometriosis" is a risk factor for surgical complications like this, even bilaterally+
lindasmith462this pissed me off so much since I got a shelf question wrong before thinking it was ureteral ligation and it was like oh the chances that they got BOTH of them instead of just one are basically non existent. uuuuuuuugh +1
submitted by โdrmohandes(193)
So the way I understood:
So there is no urine in the bladder, no urine in the abdomen, and there is bilateral hydronephrosis.
=> Both ureters ligated by accident due to Dr. LowYieldSurgeon.
(But I might be totally wrong)