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Abdominal distension and lower extremity edema

Posterior urethral valves are a congenital malformation in males that results in the obstruction of urinary outflow from the proximal urethra. Presentation depends on severity of disease, with patients presenting antenatally with oligohydramnios and hydronephrosis, to postnatally with delayed or poo...

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Autores principales: Andreas, Shaheen, Chicaiza, Henry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608138/
https://www.ncbi.nlm.nih.gov/pubmed/34849508
http://dx.doi.org/10.1002/emp2.12599
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author Andreas, Shaheen
Chicaiza, Henry
author_facet Andreas, Shaheen
Chicaiza, Henry
author_sort Andreas, Shaheen
collection PubMed
description Posterior urethral valves are a congenital malformation in males that results in the obstruction of urinary outflow from the proximal urethra. Presentation depends on severity of disease, with patients presenting antenatally with oligohydramnios and hydronephrosis, to postnatally with delayed or poor voiding, urinary tract infections, or renal anomalies on ultrasound. Our case illustrates an 11‐day‐old male who presented to the emergency department with poor feeding, vomiting, significant abdominal distension, and pitting edema of the lower extremities. The patient was found to have hypoglycemia, hyponatremia, hyperkalemia, and acute renal failure. Point of care ultrasound showed severe bilateral hydronephrosis with a significantly distended bladder that was compressing the inferior vena cava. Early recognition of the obstruction via ultrasound led to rapid decompression of the bladder using catheterization and immediate involvement of urology, nephrology, and neonatology consults in the pediatric emergency department.
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spelling pubmed-86081382021-11-29 Abdominal distension and lower extremity edema Andreas, Shaheen Chicaiza, Henry J Am Coll Emerg Physicians Open Pediatrics Posterior urethral valves are a congenital malformation in males that results in the obstruction of urinary outflow from the proximal urethra. Presentation depends on severity of disease, with patients presenting antenatally with oligohydramnios and hydronephrosis, to postnatally with delayed or poor voiding, urinary tract infections, or renal anomalies on ultrasound. Our case illustrates an 11‐day‐old male who presented to the emergency department with poor feeding, vomiting, significant abdominal distension, and pitting edema of the lower extremities. The patient was found to have hypoglycemia, hyponatremia, hyperkalemia, and acute renal failure. Point of care ultrasound showed severe bilateral hydronephrosis with a significantly distended bladder that was compressing the inferior vena cava. Early recognition of the obstruction via ultrasound led to rapid decompression of the bladder using catheterization and immediate involvement of urology, nephrology, and neonatology consults in the pediatric emergency department. John Wiley and Sons Inc. 2021-11-22 /pmc/articles/PMC8608138/ /pubmed/34849508 http://dx.doi.org/10.1002/emp2.12599 Text en © 2021 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Pediatrics
Andreas, Shaheen
Chicaiza, Henry
Abdominal distension and lower extremity edema
title Abdominal distension and lower extremity edema
title_full Abdominal distension and lower extremity edema
title_fullStr Abdominal distension and lower extremity edema
title_full_unstemmed Abdominal distension and lower extremity edema
title_short Abdominal distension and lower extremity edema
title_sort abdominal distension and lower extremity edema
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608138/
https://www.ncbi.nlm.nih.gov/pubmed/34849508
http://dx.doi.org/10.1002/emp2.12599
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