Giant Bilateral Hydronephrosis in A Newborn-A Case Report

Area of Science:

• Pediatric Urology
• Neonatal Medicine
• Fetal Medicine

Background:

• Prenatal hydronephrosis is a common finding during pregnancy.
• While often benign, it can indicate urinary tract obstruction of varying severity.
• Giant hydronephrosis presents a significant diagnostic and management challenge.

Observation:

• A case of a male neonate with prenatally diagnosed bilateral giant hydronephrosis is presented.
• The fetus exhibited massive abdominal distension due to urine accumulation, obscuring kidney parenchyma on ultrasound.
• Postnatally, the infant required intubation for respiratory distress and immediate bilateral percutaneous nephrostomy.

Findings:

• Percutaneous nephrostomy led to rapid clinical stabilization and extubation.
• Post-intervention ultrasound revealed normal kidney parenchyma and size.
• Antegrade pyelography confirmed bilateral ureteropelvic junction obstruction.
• Serum creatinine normalized within one week.

Implications:

• Severe bilateral hydronephrosis can have a favorable outcome with preserved renal function.
• Accurate prenatal diagnosis and counseling are crucial.
• Discussing various treatment options without definitive outcome prediction is advised.