An Unusual Complication of Ureteral Stone: Massive Gastric Dilatation and Duodenal Obstruction Due to Giant Hydronephrosis

Mehmet Ali Karagoz¹, Mucahit Kabar¹, Arif Demirbas¹ and Onur Telli^1,

¹Ankara Training and Research Hospital, Ankara, Turkey

Cite this paper

Mehmet Ali Karagoz, Mucahit Kabar, Arif Demirbas and Onur Telli. An Unusual Complication of Ureteral Stone: Massive Gastric Dilatation and Duodenal Obstruction Due to Giant Hydronephrosis. American Journal of Clinical Medicine Research. 2013; 1(4):51-53. doi: 10.12691/AJCMR-1-4-2

Abstract

A 42 year old man, was admitted to emergency service who suffered from nausea and vomitting for two days. In his physical examination the right side abdomen was severe distended, that had been lasting for a month. Distension was tender and cystic tough mass lesion was palbable. Plain abdominal radiography showed a 3cm radiopaque shadow in the pelvic area. Ct scan revealed massive gastric dilatation and duodenal obstruction due to giant hydronephrosis with the ureteric stone placing on the right lower ureter with a dimension of 3,5 to 3 cm. Nasogastrical decompression and right percutaneus nephrostomy catheter was performed, 5000 ml of gastric fluid and 5300 ml of nephrostomy catheter drainage was measured in the first six hours. 99m Tc-dimercaptosuccinic acid (DMSA) scan showed non-functioning right kidney and the patient finally underwent open simple nephroureterectomy. To the best of our knowledge the present patient represents one of the rarest complication of giant hydronephrosis cases reported to date.

Keywords

giant hydronephrosis, gastric dilatation, ureteral stone

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Tombari A A, Power R F, Harper J M, et al. Giant hydronephrosis: a case report with review of literature. The Journal of urology, 1968, 100(2): 120.
[2]	Stirling W C. Massive hydronephrosis complicated by hydroureter. Report of 3 cases. J Urol, 1939, 42: 520-533.
[3]	Chiang P H, Chen M T, Chou Y H, et al. Giant hydronephrosis: report of 4 cases with review of the literature. Journal of the Formosan Medical Association, 1990, 89(9): 811.
[4]	Yapanoğlu T, Alper F, Özbey Ġ, et al. Giant hydronephrosis mimicking an intraabdominal mass. Turk J Med Sci, 2007, 37: 177-179.
[5]	Shah S A, Ranka P, Dodiya S, et al. Giant hydronephrosis: What is the ideal treatment?. Indian journal of urology, 2004, 20(2): 118.
[6]	Morimitsu H, Sakaguchi M, Suzu H. Giant hydronephrosis: 2 case reports and a review of 373 cases in the literature. Nishinihon J Urol, 1990, 52: 761-766.
[7]	Lygonis C S. Intestinal Obstruction Caused by Hydronephrosis. Postgraduate medical journal, 1961, 37(426): 213.
[8]	Shudo R, Saito T, Takahashi K, et al. Giant hydronephrosis due to a ureteral stone, and elevated serum levels of CA 19-9. Internal medicine, 1999, 38(11): 887-891.
[9]	Hemal A K, Ansari M S, Doddamani D, et al. Symptomatic and complicated adult and adolescent primary obstructive megaureter—indications for surgery: analysis, outcome, and follow-up. Urology, 2003, 61(4): 703-707.
[10]	Hoffman H A. Massive hydronephrosis[J]. The Journal of urology, 1948, 59(5): 784.