Successful management of vena caval compression due to a giant hydronephrosis by retroperitoneoscopic nephrectomy

A patient with Sotos syndrome presented with a history of massive bleeding from varicose veins of the right leg, requiring hospitalization. Investigations revealed that his bilateral varicose veins and the associated leg edema were secondary to the inferior vena cava getting compressed by an asymptomatic grossly hydronephrotic right kidney. The patient was completely cured of his varicosity and leg edema following retroperitoneal laparoscopic nephrectomy. A giant hydronephrosis has produced venous thrombosis in the past, but this is the first time it was found to be responsible for bilateral varicosity of the long and the short saphenous veins due to long-standing vena caval compression.