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Published 27 February 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.08.2008.0782]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unusual association of diseases/symptoms

Paediatric unilateral giant hydroureteronephrosis from idiopathic ureterovesical stricture: a case report

Marco Zaffanello1, Milena Brugnara1, Mariangela Cecchetto2, Riccardo Manfredi3, Michele Zuffante4, Vassilios Fanos5

1 University of Verona, Department of Mother-Child and Biology-Genetics, Piazzale LA Scuro, 10, Verona, 37134, Italy
2 University of Verona, Department of Surgical-Gastroenterological Science, Piazzale LA Scuro, 10, Verona, 37134, Italy
3 University of Verona, Department of Morphological-Biomedical Science, Piazzale LA Scuro, 10, Verona, 37134, Italy
4 Verona Hospital, Department of Nuclear Medicine, Piazzale A Stefani, 1, Verona, 37134, Italy
5 University of Cagliari, Neonatal Intensive Care Unit, Via Ospedale, 19, Cagliari, 37134, Italy

Correspondence to:
marco.zaffanello{at}univr.it

SUMMARY

A congenital type of ureterovesical junction obstruction may be present in the fetus or at any stage during childhood, more commonly associated with urinary tract infections and other secondary causes. We present the case of a 6-year-old boy who suffered from colic and side pain, which was worsening monthly. He suffered from a giant hydroureteronephrosis resulting from idiopathic ureterovesical junction obstruction, with no clinical or laboratory signs of urinary tract infection or other secondary causes of obstruction. Indications for surgery were a decrease in kidney function (<40%) at scintigraphy, severe hydronephrosis (>30 mm), and the coexistence of symptoms (colic pain). After surgery, kidney function returned to almost completely normal. Unexpectedly an obstruction may become symptomatic late in infancy, especially in patients with normal prenatal ultrasound screening and postnatal life, as was the case for our patient in whom the only clinical sign was pain at flank.


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