Anuric acute renal failure due to bilateral accidental ureteric ligation during abdominal hysterectomy.
OBJECTIVE
To determine the incidence of accidental ureteric ligation causing acute anuric renal failure (AARF) at the KorleBu Teaching Hospital, Accra, Between August 1984 and December 1991.


METHODS
The records and operative data of all cases managed with acute anuric renal failure at the hospital during the period were reviewed.


RESULTS
The 7 patients with AARF presented with mean pre-referral anuria of 3.2 days. Total abdominal hysterectomy (4 for fibroids, 2 for carcinoma of uterus and 1 for post partum hemorrhage) was the cause of ureteric ligation. The 7 patients mean age 38.5 years were anemic (mean HB 4.1 g/dl) and uremic (mean blood urea 40.51 mmol/l) on admission. Abdominal ultrasonography was useful for diagnosis of obstructive uropathy. Hemodialysis was required in all cases prior to laparotomy and ureteroneocystostomy. The ureters were usually ligated at the distal 3 cm. Five survived ureteroneocystostomy and 2 died before laparatomy from septicemia and/or pulmonary edema.


CONCLUSIONS
Abdominal hysterectomy is a major cause of anuric acute renal failure and early recognition and treatment prevents death.
Mate-Kole
M O
MO
Department of Medicine and Therapeutics, University of Ghana Medical School, Accra.
Yeboah
E D
ED
Affram
R K
RK
Ghosh
T S
TS
D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D001002:Anuria / Q000209:etiology*; D003559:Cystostomy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007049:Iatrogenic Disease; D008026:Ligation; D012189:Retrospective Studies; D014513:Ureter / Q000293:injuries* / Q000601:surgery