{"id":989,"date":"2017-11-04T19:32:58","date_gmt":"2017-11-04T19:32:58","guid":{"rendered":"http:\/\/emultrasound.sdsc.edu\/?p=989"},"modified":"2020-07-22T00:04:08","modified_gmt":"2020-07-22T00:04:08","slug":"a-transplant-dilemma","status":"publish","type":"post","link":"https:\/\/emultrasound.ucsd.edu\/index.php\/2017\/11\/04\/a-transplant-dilemma\/","title":{"rendered":"Case # 9: A Transplant Dilemma"},"content":{"rendered":"
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A\u00a052 year old male with a h\/o kidney transplant presents to the emergency department with pain over his transplanted kidney site (right pelvic region). He also notes increased weakness, nausea and a significant decrease in urine output. He denies any fever. He states he is compliant with his anti-rejection medications.<\/p>\n

Vitals: T 99.0 HR\u00a0105 BP 165\/91\u00a0 RR\u00a018 O2 98% on RA<\/p>\n

A bedside ultrasound is performed, what is the next best step in management?<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Answer and Learning Points<\/h3>
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Answer<\/strong><\/p>\n

Insertion of foley catheter. The\u00a0clip above demonstrates severe hydronephrosis of the patient's transplanted kidney. A foley was inserted in the emergency department with immediate output of 1.5 L of clear urine. The patient was found to be in renal failure\u00a0secondary to his\u00a0urinary outlet obstruction. He was admitted to transplant surgery and his renal function improved over the next day; he was discharged home with a leg bag and urology follow up. Below is a repeat ultrasound of his transplanted kidney after drainage of his bladder:\u00a0<\/span><\/p>\n

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Learning Points<\/strong><\/p>\n