Open Access

RESIDENT’S CORNER

Bilateral ureteral obstruction from papillary necrosis secondary to household cleaner ingestion

Krishna Amuluru, Bradley A. Erickson, Onisura Okotie, Robert B. Nadler

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Address correspondence to Dr. Bradley A. Erickson, Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue, Tarry 16-703, Chicago, Illinois 60611 USA

Canadian Journal of Urology 2009, 16(3), 4701-4703.

Abstract

We report a case of a patient who developed bilateral hydroureteronephrosis from papillary necrosis secondary to ingestion of commercial toilet bowl cleaner. Eight days after her ingestion, acute renal failure prompted a renal ultrasound that showed bilateral hydroureteronephrosis. Emergent bilateral percutaneous nephrostomy tubes were placed and subsequent ureteroscopy revealed a large amount of obstructing necrotic material consistent with papillary necrosis. Ureteroscopic removal of the material and bilateral ureteral stents improved renal function. The etiology of this patient’s papillary necrosis was likely due to a combination of hypovolemia, systemic acidosis from the ingestion, and direct toxicity of the substance on the renal vasculature. This case demonstrates the importance of early recognition of renal insults and the extra intestinal manifestations of toxic household ingestions.

---

Keywords

---