November 2023 Medical Image of the Month: Obstructive Uropathy Extremis

Abstract

No abstract available. Manuscript truncated after 150 words. A 71-year-old veteran presented to the emergency department with two-weeks of progressive back pain radiating to the abdomen associated low-grade fever, nausea, and new lower extremity edema. The family reported confusion. His medical history was significant for chronic prostatitis and low-grade prostate cancer on biopsy that was lost to follow-up eleven years ago. His only reported medications were aspirin 81 mg daily and naproxen 500mg up to four times a day for his pain. Vitals were significant for a temperature of 36.1 C, initial blood pressure of 201/74, heart rate of 128/min, respirations at 18/min with a saturation of 97% on 2L NC. Physical exam demonstrated no difference in blood pressures between arms. No abnormal heart sounds. Clear breath sounds to auscultation bilaterally. Flank tenderness to percussion and significant abdominal tenderness over the epigastric and suprapubic region with 3+ pitting edema of the bilateral lower extremities. Screening labs were notable …

Keywords

• urinary tract obstruction
• obstructive uropathy
• bladder distension
• hydroureter
• hydronephroureter
• cystocerebral syndrome
• obstructive uropathy extremis
• urinoma
• inferior vena cava obstruction
• treatment