Patient with pelvic fracture presents with anuria. After 24 hrs bladder is not palpable. Possible diagnosis includes:
**Core Concept**
The patient's presentation is suggestive of acute urinary retention and potential kidney injury due to pelvic fracture, which may lead to a condition known as post-traumatic acute kidney injury (ATKI). This condition is characterized by a sudden decrease in renal function following a traumatic event.
**Why the Correct Answer is Right**
The patient's symptoms of anuria (absence of urine production) and non-palpable bladder after 24 hours suggest an obstruction or severe injury to the urinary tract. In this case, the pelvic fracture may have caused a urethral injury, leading to a condition known as **urethral stricture**. A urethral stricture is a narrowing of the urethra, which can cause complete or partial obstruction of urine flow, resulting in anuria.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not relevant to the patient's presentation. A **urinary tract infection (UTI)** is an infection of the urinary tract, which may cause symptoms such as dysuria, frequency, and urgency, but not typically anuria.
* **Option B:** **Renal vein thrombosis** is a blood clot in the renal vein, which can cause kidney damage and anuria, but it is not directly related to the patient's pelvic fracture.
* **Option C:** **Acute glomerulonephritis** is an inflammation of the glomeruli, which can cause anuria, but it is not directly related to the patient's pelvic fracture.
**Clinical Pearl / High-Yield Fact**
A palpable bladder is a good prognostic sign in patients with urinary retention, as it indicates that the bladder is full and the patient is likely to have an obstruction. A non-palpable bladder, on the other hand, suggests that the bladder is empty and the patient may have a more severe injury or obstruction.
**Correct Answer: C. Acute glomerulonephritis**