02-28-2008, 04:04 PM
A 62-year-old man undergoes exploratory laparotomy and repair of a bleeding duodenal ulcer.
Before the surgery, a central line is placed intraoperatively by the anesthesiologist, a Foley
catheter is inserted by the surgical resident, and cefazolin and gentamicin are given
intravenously. He is stable throughout the procedure and he makes 400 ml of urine during the
3-hour procedure. In the recovery room he is agitated and thrashing until he receives
appropriate analgesics. He is then transferred to the surgical floor where his nurse notices that
he has no urine output for 3 hours. The central venous pressure is 12 mm Hg and his blood
pressure and pulse are stable. Which of the following is the most likely etiology of this patient's
lack of urine output?
1.Acute nephrotoxicity from preoperative antibiotics
2.Bilateral renal vein thrombosis
3.Kinked Foley catheter
4.Ligation of both ureters
5.Poor renal perfusion
Before the surgery, a central line is placed intraoperatively by the anesthesiologist, a Foley
catheter is inserted by the surgical resident, and cefazolin and gentamicin are given
intravenously. He is stable throughout the procedure and he makes 400 ml of urine during the
3-hour procedure. In the recovery room he is agitated and thrashing until he receives
appropriate analgesics. He is then transferred to the surgical floor where his nurse notices that
he has no urine output for 3 hours. The central venous pressure is 12 mm Hg and his blood
pressure and pulse are stable. Which of the following is the most likely etiology of this patient's
lack of urine output?
1.Acute nephrotoxicity from preoperative antibiotics
2.Bilateral renal vein thrombosis
3.Kinked Foley catheter
4.Ligation of both ureters
5.Poor renal perfusion