Barium and fecal impaction: an unusual case of bilateral hydronephrosis

We present an interesting case report of the second adult female reported to suffer from bilateral ureteral hydronephrosis, secondary to a fecal impaction, and the first caused by complications from residual barium. This elderly patient suffers from many associated neurologic, bowel, and urinary tract problems; this case report demonstrates their close proximal relationship. Through ureteral stent placement and manual disimpaction of the barium fecaloma, the patient was able to recover her normal renal and bowel functions. Aided by the use of excellent figures, it is our intent to inform physicians that they should consider fecal impaction as a cause for bilateral ureteral hydronephrosis in predisposed patients, and also the necessity of purging the GI tract of residual barium following radiologic studies.