A CASE OF ACUTE RENAL FAILURE DUE TO EXTRINSIC URETERAL OBSTRUCTION INDUCED BY PELVIC ENDOMETRIOSIS

The paper reports a 40-year-old woman who developed acute renal failure after extrinsic ureteral obstruction attributed to pelvic endometriosis, presenting with nausea, vomiting, generalized edema, and a lower abdominal mass. High-level evaluation using retrograde pyelography showed left distal ureteral narrowing with hydroureteronephrosis; she previously had endometriosis causing right ureteral obstruction requiring nephroureterectomy, and the authors proceeded with surgery in May 1982. Intraoperatively, a left ovarian endometriotic cyst was found alongside a mass in which the ileum and distal ureter were adherent, and excision of fibrous endometriosis tissue around the left ureter plus temporary nephrostomy led to restored ureteral flow; the fibrous tissue was confirmed as endometriosis on pathology, and the authors also gave postoperative irradiation. The follow-up at 11 months after nephrostomy removal documented normal lab values and good health, with the main limitation being that this is a single case report (no generalizable comparative evidence). This paper is centrally about endometriosis — it describes acute renal failure caused by endometriosis-induced extrinsic ureteral obstruction and surgical management with pathologic confirmation.

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