Abdominal distension and lower extremity edema

Abstract 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 delay...

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Main Authors: Shaheen Andreas, Henry Chicaiza
Format: Article
Language:English
Published: Elsevier 2021-12-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12599
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author Shaheen Andreas
Henry Chicaiza
author_facet Shaheen Andreas
Henry Chicaiza
author_sort Shaheen Andreas
collection DOAJ
description Abstract 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 doaj-art-666ca76baf1d4c05b3a2d02e7ade20f12025-08-20T03:04:07ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-12-0126n/an/a10.1002/emp2.12599Abdominal distension and lower extremity edemaShaheen Andreas0Henry Chicaiza1Connecticut Children's Hospital Hartford Connecticut USAConnecticut Children's Hospital Hartford Connecticut USAAbstract 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.https://doi.org/10.1002/emp2.12599emergency medicinepoint of care ultrasoundposterior urethral valves
spellingShingle Shaheen Andreas
Henry Chicaiza
Abdominal distension and lower extremity edema
Journal of the American College of Emergency Physicians Open
emergency medicine
point of care ultrasound
posterior urethral valves
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 emergency medicine
point of care ultrasound
posterior urethral valves
url https://doi.org/10.1002/emp2.12599
work_keys_str_mv AT shaheenandreas abdominaldistensionandlowerextremityedema
AT henrychicaiza abdominaldistensionandlowerextremityedema