Bilateral ureteral obstruction after appendicectomy.

Acute renal failure due to bilateral ureteral obstruction is a rare complication after appendectomy in children. We report a case of anuria in an 11-year-old boy five days after surgery for a perforated acutely inflamed appendix. No abscess was found with CT. After saline-filling of the urinary bladder, transabdominal ultrasound demonstrated echogenic "plugs" in the distal parts of both ureters. Cystoscopy revealed inflammatory changes in the bladder base. Following introduction of bilateral ureteric stents, there was rapid normalisation of urinary output and serum creatinine. A review of the literature disclosed 15 similar cases, all boys in the age group 6 to 15 years.