Abstract
A 42-year-old man with no medical history complaining of back pain for several months with bilateral sciatica poorly systematized. Radiographs of the lumbar spine show a narrowing of the L4/L5 disc space. A lumbar spine Computed Tomography (CT) was requested to explore these low back pain. It revealed a medial disc herniation at the L4-L5 level and discovers a large cystic swelling with thin septations occupying whole of the abdomen (Fig. A). Contrast-enhanced abdominal CT scan confirmed left giant hydronephrosis secondary to pelviureteric junction obstruction (Fig. B) with thin renal parenchyma (white arrowheads) (Fig. 3). It’s shifting all the bowel loops to the right side. Non left ureteral stone, never mass syndrome has been highlighted. Left nephrectomy was performed and approximately 8 liters of clear urine was drained. The patient had an uneventful recovery postoperatively.
Highlights
Enhanced abdominal Computed Tomography (CT) scan confirmed left giant hydronephrosis secondary to pelviureteric junction obstruction (Fig. B) with thin renal parenchyma (Fig. 3)
Giant hydronephrosis is a rare condition, defined as the presence of massive dilatation of renal collecting system containing more than a liter of fluid
Patients present with flank pain, hematuria, recurrent urinary tract infection or low back pain like in our patient
Summary
Enhanced abdominal CT scan confirmed left giant hydronephrosis secondary to pelviureteric junction obstruction (Fig. B) with thin renal parenchyma (white arrowheads) (Fig. 3). Approximately 8 liters of clear urine was drained. The patient had an uneventful recovery postoperatively.
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