左上半部巨大腎水腫引發骨牌效應並壓迫下腔靜脈誘發暈厥

陳慧雅、何東儒、陳志碩、林威宇、黃雲慶、林健煇、黃國財、劉昱良

嘉義長庚紀念醫院 外科部 泌尿科

Domino effect of left upper moiety giant hydronephrosis with compression to inferior vena cava induce syncope

Wai-Nga Chan*, Dong-Ru Ho, Chih-Shou Chen, Wei-Yu Lin, Yun-Ching Huang, Jian-Hui Lin, Kuo-Tsai Huang, Yu-Liang Liu

Divisions of Urology, Department of Surgery, Chang Gung Medical Foundation, Chiayi City, Taiwan

Introduction:

Duplex collecting system is a congenital condition is a common etiology of hydronephrosis. Grade IV hydronephrosis was defied as severe thinning of the cortical parenchyma (2 mm) and cyst-like hydronephrotic kidneys by Society of Fetal Urology hydronephrosis grading system. Massive dilation of the renal pelvis where the kidney occupies the hemiabdomen, crosses midline, or is at least five vertebral bodies in length was first described as “giant hydronephrosis” by Crooks et al., in 1979.1 Hydronephrosis presenting as a cystic abdominal mass is uncommon but has been previously reported. However, massive left side hydronephrosis causing compression of the inferior vena cava is exceedingly rare reported in the literature. Here, we report a 77-year old male presenting with syncope and fall who was found to have obstruction of the left upper pole moiety in renal duplication with massive hydronephrosis causing abdominal aorta aneurysm and inferior vena cava compression.