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Bilateral Pyosalpinx Causing Obstructive Hydronephrosis: A Multimodality Imaging Approach with the Emphasis on the
Urban Čizmarević1, Maja Podkrajšek1, Nina Hanžič1
1Radiology, University Medical Centre Maribor, Maribor, SVN.
Cureus
|January 1, 2020
Summary
A woman with flank pain was found to have hydronephrosis caused by large cystic changes in her fallopian tubes. These cysts compressed the ureters, leading to kidney swelling and pain.
Area of Science:
- Gynecology
- Urology
- Radiology
Background:
- Urinary tract infections (UTIs) can present with varied symptoms.
- Flank pain is a common symptom requiring diagnostic investigation.
Observation:
- A 40-year-old female presented with increasing left flank colic pain.
- Ultrasound revealed right-sided hydronephrosis.
- Computed tomography (CT) identified large cystic changes in both fallopian tubes compressing the ureters.
Findings:
- Magnetic resonance imaging (MRI) demonstrated fluid-fluid levels within the cystic fallopian tube changes.
- Differential diagnoses included deep pelvic endometriotic cyst and pyosalpinx.
- The cystic masses were the cause of ureteral compression and subsequent hydronephrosis.
Implications:
- This case highlights the importance of considering gynecological pathology in patients with unexplained hydronephrosis.
- Advanced imaging like CT and MRI are crucial for diagnosing complex pelvic conditions.
- Accurate diagnosis is essential for appropriate management of ureteral obstruction and associated pain.
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