A Case of Urinary Retention in an Adolescent Female

Abstract

A 15-year-old female presented to our emergency department with complaints of anuria for over 24 hours. She also had diffuse non-radiating abdominal pain, abdominal distention, and increased frequency of stools for the last 4 days. The patient had an unremarkable past medical history and reported no medication use. At presentation, she was afebrile, with a heart rate of 90 beats per minute, respiratory rate of 15 per minute, blood pressure of 118/82 mm of Hg, and saturation of 99% on room air. Physical examination revealed a distended abdomen with tenderness over the lower quadrants, with no guarding or rigidity. A hard mass was palpable in the lower quadrant of the abdomen and bowel sounds were normal. The genito-urinary examination was normal. Straight urethral catheterization resulted in 300 ml of amber-coloured urine. She had no laboratory abnormalities with normal renal function and a creatinine of 0.6 mg/dl. Computerized tomography (CT) of the abdomen and pelvis with contrast is shown in Figures 1 and 2. The CT revealed marked dilation of the sigmoid colon, measuring over 13 cm with a large amount of fecal matter. The urinary bladder was compressed and displaced laterally to the right, and no hydronephrosis was noted.