Giant hydronephrosis : a rare cause of gross abdominal distension

Giant Hydronephrosis: A Rare Case Report and Literature Review

“…GH occurs in all age groups, but the majority of described cases occur in the pediatric population due to the development of prenatal ultrasound [8, 11, 18]. GH may be congenital or acquired, but is most often caused by congenital obstruction of the pyeloureteral junction [10, 11, 18]. Congenital pyeloureteral junction syndrome is a functional obstruction from abnormalities of the pyeloureteral smooth muscle [9, 19].…”

“…Respiratory distress is explained by diaphragmatic pressure and cardiovascular changes exerted by GH [8]. The differential diagnosis includes massive ascites, cysts (hepatobiliary, mesenteric, pancreatic, adrenal, echinococcal liver, and ovarian), splenomegaly, pseudomyxomas, and tumors (renal, retroperitoneal, and ovarian) [7, 9, 10, 26]. Diagnostic tools include anterograde or retrograde urography and ultrasonography, but CT with contrast remains the gold standard for diagnosing hydronephrosis [8, 9, 11].…”

“…The first described case of GH dates back to 1,746. Although more than 600 cases have been reported in the literature since then [5][6][7][8][9], fewer than 10 cases contained 15 or more liters of fluid, and none had pulmonary and vascular repercussions as their initial presentation [10][11][12][13][14][15][16][17] (Table 1). In our case, the hydronephrotic kidney contained 27 L of urine and was responsible for dyspnea and lower extremity edema.…”