Giant Hydronephrosis Mimicking an Intraabdominal Mass: Case Report

Abstract

Giant hydronephrosis (GH) is a rare entity that may mimic progressive and benign abdominal cystic tumor, is defined as a collection of more than 1 litre of urine in the excretory cavities or as a dilation beyond the mid-abdominal line with a kidney length exceeding 5 vertebrae in children. It is rare, often due to a pyelo ureteral junction syndrome. The antenatal ultrasound must make the diagnosis before birth. We report the case of an 2-month-old infant, brought to the consultation for progressive abdominal distension since birth but aggravated since 1 month. The physical examination had revealed an abdominal mass occupying the whole abdomen, but more marked on the right, taut and matt to the percussion and whose limits and origin were difficult to determine. The abdominopelvic ultrasound had shown an echo-fluid structure mass extending from the right hypochondrium to the pelvis and well beyond the midline. The urotomodensitometry (uro-TDM) had shown at right giant hydronephrosis in the form of a voluminous liquid mass extending from the subhepatic region into the pelvis beyond the midline. This mass was surrounded by a thin parenchymal border with an elevation corresponding to the renal parenchyma.