Ureteropelvic junction obstruction: case report

Abstract

Introduction: Pyeloureteral stenosis is a congenital anomaly associated with narrowing of the lumen of the pyeloureteral junction. It occurs in approximately 1 in every 1,500 live births. Case description: A 6-year-old male patient with a history of diffuse abdominal pain in the right hemiabdomen, accompanied by nausea, vomiting, and difficulty walking, with a duration of 6 hours. Physical examination revealed no palpable masses and no evidence of peritoneal irritation. Abdominal ultrasound revealed right hydronephrosis; a contrast-enhanced CT pyelogram was performed, confirming the diagnosis of right hydronephrosis and right-sided ureteropelvic junction stenosis. The patient underwent Anderson-Hynes split pyeloplasty, and his postoperative course was satisfactory. During surgery, a transanastomotic percutaneous nephroureterostomy catheter was placed, which provides two advantages: it reduces the risk of junction restenosis and avoids the placement of a double J catheter, since its removal requires the patient to undergo a new endoscopic surgical procedure under general anaesthesia. Conclusion: Early diagnosis, if possible during the prenatal stage, is essential, as late diagnosis often alters the prognosis. It should be noted that in countries where economic resources are scarce, this type of technique reduces costs, as removal is performed by percutaneous traction 7-21 days.