A patient operated for lower segment uterine fibroid had an uneventful surgery. Post operatively the urine output staed to decrease, upto 20 ml/hr. Rapid IV fluid infusions were given with injlasix and output increased to 70 ml/hr. Urine was clear. Patient complained of flank pain which was gradually progressing. Most common cause of such presentation would be:

**Core Concept**
The patient's presentation suggests acute kidney injury (AKI), likely due to a complication of the surgical procedure, specifically related to the postoperative management of fluid status and potential nephrotoxic effects of the diuretic used.

**Why the Correct Answer is Right**
The patient's initial oliguria (decreased urine output) improved with rapid IV fluid infusions and the administration of furosemide (injlasix), a loop diuretic. However, the subsequent development of flank pain and the progression of symptoms suggest a possible complication of the surgery, such as a urinary tract injury or a hematoma compressing the ureter or renal vessels. The most likely cause of this presentation is a **urological complication**.

**Why Each Wrong Option is Incorrect**
* **Option A:** While acute kidney injury can be caused by various factors, including hypovolemia, sepsis, or nephrotoxicity, the patient's presentation and response to treatment do not strongly suggest these causes as the primary concern.
* **Option B:** The patient's symptoms do not specifically suggest a **hemorrhagic shock**, which would typically present with signs of hypotension, tachycardia, and decreased urine output.
* **Option C:** A **postoperative infection** could be a concern, but the patient's symptoms do not specifically suggest this diagnosis, and the clear urine output makes it less likely.

**Clinical Pearl / High-Yield Fact**
In patients with postoperative oliguria, it is essential to consider the possibility of a urological complication, such as a urinary tract injury or a hematoma compressing the ureter or renal vessels, and to investigate these causes promptly to prevent further complications.

**Correct Answer:** C

✓ Correct Answer: B. Unilateral uretric injury