WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster - 113

Neglected Ureteropelvic Junction Obstruction Leading to Giant Hydronephrosis: A Case Report and Review of Literature

Fatemeh Sadeghi Ardakani 1, Ali Samady Khanghah 2, Mahdi Sonei 1, Mahta Sadeghi Ardakani 1, Khashayar Atqiaee 1
1 Mashhad University of Medical Sciences
2 Ardabil University of Medical Sciences

Abstract

Introduction: Giant hydronephrosis (GH) is an uncommon urological disease, and ureteropelvic junction obstruction (UPJO) is counted as one of the most common etiologies among children. A kidney comprising more than 1.6% of the overall body weight is a giant hydronephrotic kidney. The possible differential diagnoses may include ovarian, mesenteric, pancreatic, and adrenal cysts, extra-renal tumors, Echinococcal cysts of the liver, non-renal retroperitoneal cysts, tuberculous peritonitis, and ascites. Due to the possibility of pyelonephritis, sepsis, and shock, paracentesis is not recommended in these cases. Ultrasonography is the primary modality employed to distinguish the diagnoses mentioned above. Our survey of the pediatric population revealed that aside from UPJO, the most common anomalies were renal system duplication.

Case presentation: This report presents a giant hydronephrosis resulting from a neglected complication of ureteropelvic junction obstruction in a 2.5-year-old girl with a history of gross hematuria and abdominal distention who underwent nephrectomy.

A kidney comprising more than 1.6% of the overall body weight is a giant hydronephrotic kidney. The possible differential diagnoses may include ovarian, mesenteric, pancreatic, and adrenal cysts, extra-renal tumors, Echinococcal cysts of the liver, non-renal retroperitoneal cysts, tuberculous peritonitis, and ascites. Due to the possibility of pyelonephritis, sepsis, and shock, paracentesis is not recommended in these cases. Ultrasonography is the primary modality employed to distinguish the diagnoses mentioned above. Our survey of the pediatric population revealed that aside from UPJO, the most common anomalies were renal system duplication.

Conclusion: Care for patients with GH is tailored to each individual, with significant differences between children and adults.

Permission has been obtained from the patient's legal guardian.

Keywords: Hydronephrosis, Ureteropelvic Junction Obstruction, Hematuria, CT scan, Case report

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