Ureterosigmoidostomy and obstructive uropathy.
BACKGROUND
A 19-year-old mentally retarded man with failed exstrophy repair and ureterosigmoidostomy urinary diversion presented with high fever, vomiting and right-flank pain of 2 days' duration. Past medical history was notable for a left nephrectomy to treat an infected staghorn calculus in a poorly functioning kidney. Physical examination revealed pyrexia and right-flank tenderness.


METHODS
Physical examination, renal function tests, electrolyte and metabolic assessment, urine and blood cultures, abdominal CT, ANTEGRADE PYELOURETEROGRAPHY, sigmoidoscopy and histopathology.


METHODS
Ureterosigmoidostomy complicated by acute pyelonephritis, obstructive uropathy, recurrent urinary tract infections, renal impairment and the development of renal stones and metabolic acidosis.


RESULTS
Fluids, intravenous antibiotics, bicarbonate and potassium supplementation, and rediversion of ureterosigmoidostomy to an ileal conduit.
Yossepowitch
Ofer
O
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. oferyoss@netvision.net.il
Baniel
Jack
J
D000328:Adult; D012809:Colon, Sigmoid / Q000601:surgery*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D011704:Pyelonephritis / Q000209:etiology*; D014517:Ureteral Obstruction / Q000209:etiology*; D014519:Ureterostomy / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000209:etiology*