1/22. Giant hydronephrosis due to ureteropelvic junction obstruction in a child: CT and MR appearances.Giant hydronephrosis caused by congenital ureteropelvic junction (UPJ) obstruction is a rare urological entity in childhood. We report a case of giant hydronephrosis in a 12-year-old boy presented with abdominal distension. Radiological features of this rare entity are discussed with an overview of sonographic findings, especially including CT and MR appearances. The current literature is also reviewed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. Retroperitoneal fat necrosis producing ureteral obstruction.We present 3 cases of a rare syndrome of extrinsic ureteral obstruction produced by retroperitoneal fat necrosis and compare the medical records and histopathology to 19 cases of classic idiopathic retroperitoneal fibrosis. Clinical similarities include average age of onset in the fourth and fifth decades, male preponderance, abdominal or back pain as the presenting symptom, elevation of the blood urea concentration prior to diagnosis and tendency toward bilateral involvement. Histologically, the 2 conditions were different. Retroperitoneal fat necrosis is characterized by coalescence of fat cells into fat cysts bordered by foreign body giant cell granulomas, foam cells, light chronic inflammatory infiltrate and unimpressive fibrosis. The microscopic pathology of idiopathic retroperitoneal fibrosis is dominated by densely collagenized fibrous tissue of varying cellularity without evidence of fat necrosis. Of the 3 cases of retroperitoneal fat necrosis 2 featured prior ischiorectal abscesses and this is considered in a discussion of the etiology of this unusual cause of ureteral compression.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/22. Extensive retroperitoneal fibrosis with duodenal and ureteral obstruction associated with giant inflammatory aneurysm of the abdominal aorta.We report a case of abdominal aortic aneurysm complicated by retroperitoneal fibrosis with both duodenal and bilateral ureteral obstruction. The patient underwent successful bilateral transurethral ureteral stenting, and then he was referred for surgical treatment of the aneurysm. Massive retroperitoneal fibrosis was found at surgery, and the mass was removed along with the diseased aorta, which was replaced by a bifurcated Dacron prosthesis; duodenolysis and ureterolysis were concomitantly performed. Ureteral stents were removed on the 8th postoperative day. Follow-up assessment at 1 year showed normalization of the urinary tract structure at echography and good hemodynamic performance of the vascular prosthesis at Doppler examination. To our knowledge, no other case of duodenal and bilateral ureteral stenosis secondary to massive retroperitoneal reactive fibrosis in association with abdominal aortic aneurysm has been reported.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
4/22. A spontaneous giant urinoma: a cause of abdominal mass.OBJECTIVES: To report a case of unilateral ureteral obstruction associated with giant retroperitoneal urinoma which was treated successfully by percutaneous drainage. methods: A 19G ultrasound guided needle was introduced into the mass and after dilatation procedure, a 14 Fr nephrostomy catheter was placed and 5.5 of liquid were drained. RESULTS: drainage from the nephrostomy catheter stopped 24 hours later. Patient was discharged with the nephrostomy tube. One week later, on control tomography, absence of left renal suprahilar posteromedial focal cortical contour was seen. CONCLUSIONS: A minor cortical or forniceal rupture with no urinary extravasation on radiographic examination is thought to be the cause of this urinoma. Percutaneous drainage may be considered as an alternative treatment option to surgical intervention in the treatment of urinomas, especially when there is no persistent ureteral obstruction or communication between the collecting system and the urinoma.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/22. Giant ureteral stone associated with partial ureteral duplication.We are presenting a 36-year-old male patient with right flank pain and a history of recurrent urinary tract infection for three years. Radiographic intervention revealed a right partial ureteral duplication with a giant stone in size 9.6 cm in the ureteral limb draining the non-functioning upper pole of the right kidney. Open ureterolithotomy and partial nephroureterectomy was performed by a right flank incision. The presence of a ureteral partial duplication created a "yo-yo phenomenon", which interfered with stone passage to the bladder and may cause such giant ureteral stone.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/22. An unusual cause of complete distal ureteral obstruction: giant fibroepithelial polyp.Fibroepithelial polyp of the ureter is a rare benign neoplasm of mesodermal origin. It is an extremely rare cause of hydronephrosis in children. It usually causes partial ureteral obstruction without loss of renal function. The preferred treatment is endoscopic or surgical resection of the polyp with preservation of the renal unit. The authors present an adolescent patient with a nonfunctioning left hydronephrotic kidney caused by complete ureteral obstruction caused by a giant fibroepithelial polyp of the distal ureter. This is an extremely rare presentation and outcome of this benign ureteral neoplasm with resultant loss of renal unit.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/22. Distal ureteral atresia: recovery of renal function after relief of obstruction at ten months old.A large cystic mass that occupied more than half of the abdomen was identified by ultrasound in a 10-month-old boy. Intravenous pyelography failed to visualize the right kidney, so we created a loop ureterocutaneostomy followed by temporary nephrostomy to improve renal function. Exploratory surgery revealed complete atresia of the distal right ureter. A ureteral stricture developed after ureteroneocystostomy and undiversion of the loop, so a second reconstruction procedure was required (pelvi-ureteroplasty and reimplantation of the right ureter with a psoas hitch) to free the patient from dependence on catheters. Despite the occurrence of giant hydronephrosis secondary to complete ureteral obstruction at the age of 10 months, the function of the right kidney could be preserved. Accordingly, aggressive attempts to promote functional recovery may be justified even when patients have advanced hydronephrosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/22. Giant hydroureteronephrosis associated with primary obstructed megaureter.The case is presented of a four year old boy with a large left abdominal mass. The patient was diagnosed as having a left giant hydroureteronephrosis due to a primary obstructed megaureter, based on the findings of ultrasonography, micturating cystourethrography, excretion urography, computed tomography and percutaneous antegrade pyeloureterography. Diuretic renography showed that the obstruction was partial. Since a static renal scintigram indicated that renal function on the affected side was moderately well preserved, ureteroplasty is planned.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/22. Giant sclerosing leiomyoma of bladder presenting as chronic renal failure.The clinical and pathologic features of a case of giant sclerosing leiomyoma of the bladder in a male Polynesian patient are reported. The presenting complication of chronic renal failure due to tumor envelopment of both ureters and consequent bilateral renal obstruction appears to be unique in the literature.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/22. Boari flap calycovesicostomy: a salvage procedure for giant hydronephrosis due to ureteropelvic junction obstruction.The surgical management of two patients with giant hydronephrosis in a solitary kidney treated by Boari flap calycovesicostomy is presented. In one patient, this operation was done following unsuccessful previous pyeloplasty, while in the other this was done as the primary operation. Though free reflux was observed in both the cases, the refluxed contrast emptied satisfactorily after double voiding. No deterioration of renal function was noted during the follow-up period of 12 months.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
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