Adult Giant Hydronephrosis Presenting with Spontaneously Resolving Right Upper Quadrant Pain and Shortness of Breath
Speaker Credentials
Other
Speaker Credentials
MD
Medical Specialty
Internal Medicine
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
1
Abstract
Introduction: Giant hydronephrosis (GH) is defined by hydronephrosis involving more than 1 liter of fluid or 1.6% of body weight in fluid in the renal collecting system, crossing the midline, or extending at least five vertebrae lengths in size. GH is a rare condition with about 600 reported cases in the literature, with the majority affecting children and typically caused by ureteral pelvic junction (UPJ) obstruction. Case Description: We report the case of a 57-year-old male with a history of recurrent bilateral kidney stones requiring shock wave lithotripsy and ureteral stent placement, chronic kidney disease, anemia, and hypertension presenting with a 4-day history of right upper quadrant pain and shortness of breath. The patient was found to have a 5 mm kidney stone at the right UPJ, causing obstruction and severe right-sided hydronephrosis, extending seven vertebrae lengths in size. The next day, the patient was asymptomatic and chose to postpone nephrostomy tube placement until returning from an upcoming trip. Twelve days later, the patient followed up outpatient and had a nephrostomy tube placed. A follow-up visit was scheduled for eight weeks. Discussion: This case highlights a unique presentation of giant hydronephrosis in which the patient presented initially with right upper quadrant pain and became completely asymptomatic the next day.
Adult Giant Hydronephrosis Presenting with Spontaneously Resolving Right Upper Quadrant Pain and Shortness of Breath
Introduction: Giant hydronephrosis (GH) is defined by hydronephrosis involving more than 1 liter of fluid or 1.6% of body weight in fluid in the renal collecting system, crossing the midline, or extending at least five vertebrae lengths in size. GH is a rare condition with about 600 reported cases in the literature, with the majority affecting children and typically caused by ureteral pelvic junction (UPJ) obstruction. Case Description: We report the case of a 57-year-old male with a history of recurrent bilateral kidney stones requiring shock wave lithotripsy and ureteral stent placement, chronic kidney disease, anemia, and hypertension presenting with a 4-day history of right upper quadrant pain and shortness of breath. The patient was found to have a 5 mm kidney stone at the right UPJ, causing obstruction and severe right-sided hydronephrosis, extending seven vertebrae lengths in size. The next day, the patient was asymptomatic and chose to postpone nephrostomy tube placement until returning from an upcoming trip. Twelve days later, the patient followed up outpatient and had a nephrostomy tube placed. A follow-up visit was scheduled for eight weeks. Discussion: This case highlights a unique presentation of giant hydronephrosis in which the patient presented initially with right upper quadrant pain and became completely asymptomatic the next day.