Saleh Al-Ajmi1 and Amal A. Al-Eisa2*
1Department of Pediatrics, Adan Hospital-Ministry of Health, Kuwait
2Department of Pediatrics, Kuwait University, Kuwait
Background: Acute kidney injury due to bilateral ureteral obstruction is a rare complication following appendectomy in children. In this report, we present a 9- year old boy who developed gross hematuria and anuria 6 days post- appendectomy.Case: The child presented with acute abdominal pain, fever and vomiting. Acute appendicitis was suspected and laparoscopic appendectomy was performed. The Appendix was found to be retro- Cecal in position and perforated with gangrenous tip. On the 6th postoperative day, he developed AKI with anuria, Serum creatinine peaked to 239 μmol/l after a base- line reading of 30 μmol/l /l on day of admission. Ultrasound and CT scan of the abdomen revealed bilateral hydronephrosis and hydroureters with curvilinear hyper dense shadows in course of distal ureters. Cystoscopy revealed congestions and edema at bladder base, trigon and around both ureteric orifices. AKI resolved completely within 2 days after cystoscopic bilateral stenting of both ureters.
Conclusion: AKI should be anticipated in male pediatric patients undergoing appendectomy with a retro-Cecal position. Preemptive ureteric stent insertion might be a good prophylactic option.
Acute Kidney Injury (AKI); Appendectomy; Retro-Cecal; Hypercalciuria
Al-Ajmi S, Al-Eisa AA. Acute Kidney Injury Following Retro-Cecal Appendectomy in a Male Child. Clin Surg. 2017; 2: 1321.