Bilateral Ureteral Obstruction

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Abstract
Dr. Dale E. Wenlund: This 63-year-old man was well until about one and a half years prior to the present admission, when he had a cholecystectomy. He subsequently noted a painful bulge in the region of the subcostal scar. Because of pain and anorexia, he lost 30 lb (1.36 kg) during the next 18 months and was unable to work. He entered the emergency ward with an obvious ventral hernia. Approximately 30 years prior to the present admission he had undergone a laparotomy for intestinal obstruction. There was no history of postoperative difficulty. Physical examination revealed an intelligent, cooperative male in good physical condition. His blood pressure level was 140/90 mm Hg; pulse, 82; and temperature, 99 F ( 210 C). He had no urinary symptoms. The abdomen was unremarkable except for an obvious ventral hernia. The hematocrit value was 32%. The white blood count and serum electrolyte levels were normal.

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