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A complex case of abdominal pain in a patient with pelviureteric junction obstruction

Przemysław Wolak1, Tomasz Golabek2, Mateusz Obarzanowski3

  • 1Institute of Nursing and Obstetrics, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland ; Department of Pediatric Surgery, Urology and Traumatology, Wladyslaw Buszkowski Children's Hospital, Kielce, Poland.

Wideochirurgia I Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques
|August 7, 2014
PubMed

Insights

Pelviureteric junction (PUJ) obstruction can cause abdominal pain. A case report details a laparoscopic pyeloplasty where an appendix with adhesions was found to be a dual pathology contributing to the obstruction.

Area of Science:

  • Urology
  • Surgical Case Reports

Background:

  • Pelviureteric junction (PUJ) obstruction is a common condition in adults and children.
  • Congenital anomalies and crossing renal vessels are frequent causes of PUJ obstruction.

Observation:

  • A young woman presented with intermittent abdominal pain and right-sided hydronephrosis.
  • Laparoscopic Anderson-Hynes pyeloplasty was planned for the diagnosed PUJ obstruction.

Findings:

  • During surgery, a partly extraperitoneal appendix with adhesions was found adhered to the ureter below the obstructed PUJ.
  • The appendix and its adhesions were identified as a likely dual pathology contributing to the patient's symptoms.

Implications:

  • This case highlights the importance of considering atypical causes of PUJ obstruction.
  • Concurrent appendectomy during pyeloplasty may be beneficial in select cases with dual pathologies.

Keywords:
abdominal painincidental appendectomylaparoscopic pyeloplastypelviureteric junction obstruction

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