Giant hydronephrosis (GH), characterized by the presence of more than 1 L of fluid in the renal collecting system, is a rare urological condition, particularly in adults. Obstruction of the pyeloureteral junction is the most common cause of GH. We report the case of a 51-year-old man who presented with dyspnea, edema of the lower limbs, and major abdominal distension. The patient was diagnosed with obstruction of the pyeloureteral junction, causing a left giant hydronephrotic kidney. After renal drainage of 27 L of urine, a laparoscopic nephrectomy was performed. GH usually manifests as asymptomatic abdominal distension or vague symptoms. However, very few published reports describe cases of GH initially presenting with respiratory and vascular manifestations.

1.
Kaura
KS
,
Kumar
M
,
Sokhal
AK
,
Gupta
AK
,
Purkait
B
,
Saini
D
,
.
Giant hydronephrosis: still a reality
.
Turk J Urol
.
2017 Sep
;
43
(
3
):
337
44
.
2.
Patel
K
,
Batura
D
.
An overview of hydronephrosis in adults
.
Br J Hosp Med
.
2020 Jan 2
;
81
(
1
):
1
8
.
3.
Sterling
WC
.
Massive hydronephrosis complicated by hydroureter. Report of 3 cases
.
J Urol
.
1939
;
42
:
520
33
.
4.
Crooks
KK
,
Hendren
WH
,
Pfister
RC
.
Giant hydronephrosis in children
.
J Pediatr Surg
.
1979 Dec
;
14
(
6
):
844
50
.
5.
Alsunbul
A
,
Alzahrani
T
,
Binjawhar
A
,
Aldughiman
A
,
El-Tholoth
HS
,
Alzahrani
A
,
.
Giant hydronephrosis management in the Era of minimally invasive surgery: a case series
.
Int J Surg Case Rep
.
2020
;
75
:
513
6
.
6.
Para
SA
,
Wani
SA
,
Murty
K
.
Giant hydronephrotic kidney in adolescence- A rare case report and a review of the literature
.
Urol Case Rep
.
2020
;
28
:
101029
.
7.
Hassen
SM
,
Issack
FH
,
Mummed
FO
,
Hassen
IK
.
Giant hydronephrosis secondary to ureteropelvic junction obstruction, a rare occurrence, case report
.
Urol Case Rep
.
2021 Aug 10
;
39
:
101803
.
8.
Budigi
B
,
Dyer
RB
.
“Giant” hydronephrosis
.
Abdom Radiol
.
2019 May
;
44
(
5
):
1946
8
.
9.
Hu
G
,
Luo
M
,
Xu
Y
.
Giant hydronephrosis secondary to ureteropelvic junction obstruction in adults: report of a case and review of literatures
.
Int J Clin Exp Med
.
2015 Mar 15
;
8
(
3
):
4715
7
.
10.
Abeygunasekera
AM
,
Harischandra
DV
,
Udayakumara
ED
.
Giant hydronephrosis: a rare cause of gross abdominal distension
.
Ceylon Med J
.
2004 Jun
;
49
(
2
):
66
.
11.
Wang
QF
,
Zeng
G
,
Zhong
L
,
Li
QL
,
Che
XY
,
Jiang
T
,
.
Giant hydronephrosis due to ureteropelvic junction obstruction: a rare case report, and a review of the literature
.
Mol Clin Oncol
.
2016 Jul
;
5
(
1
):
19
22
.
12.
Talukder
BC
,
Chatterjee
SC
,
Agarwal
TN
,
De
PP
.
Giant hydronephrosis
.
Br J Urol
.
1979 Aug
;
51
(
4
):
322
3
.
13.
Schrader
AJ
,
Anderer
G
,
von Knobloch
R
,
Heidenreich
A
,
Hofmann
R
.
Giant hydronephrosis mimicking progressive malignancy
.
BMC Urol
.
2003 Oct 18
;
3
:
4
.
14.
Pattanshetti
VM
,
Swamy
MK
,
Neeli
SI
,
Godhi
AS
,
Metgud
SC
.
Giant hydronephrosis
.
Indian J Surg
.
2010 Jul
;
72
(
Suppl 1
):
359
60
.
15.
Wu
CC
,
Sun
GH
.
Giant hydronephrosis
.
Mayo Clin Proc
.
2009 Nov
;
84
(
11
):
954
.
16.
Tazi
MF
,
Riyach
O
,
Ahallal
Y
,
Mellas
S
,
Khallouk
A
,
El Fassi
MJ
,
.
Giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction: one case report and literature review
.
Case Rep Urol
.
2012
;
2012
:
817519
.
17.
Vilares
RN
,
Jesus
VM
,
Talizin
TB
,
Carvalho Dos Anjos Silva
G
,
Cezarino
BN
,
Arap
MA
.
Previously unseen 80L giant hydronephrosis
.
Urol Case Rep
.
2020 Sep 23
;
33
:
101426
.
18.
Ardiçoğlu
A
,
Yüzgeç
V
,
Atikeler
MK
,
Ozdemir
E
.
A case of adult giant hydronephrosis as unusual cause of intraabdominal mass
.
Int Urol Nephrol
.
2003
;
35
(
1
):
7
8
.
19.
Mendelsohn
C
.
Functional obstruction: the renal pelvis rules
.
J Clin Invest
.
2004 Apr
;
113
(
7
):
957
9
.
20.
Kaya
C
,
Pirincci
N
,
Karaman
MI
.
A rare case of an adult giant hydroureteronephrosis due to ureterovesical stricture presenting as a palpable abdominal mass
.
Int Urol Nephrol
.
2005
;
37
(
4
):
681
3
.
21.
Demirtaş
A
,
Sahin
N
,
Akınsal
EC
,
Ekmekçioğlu
O
,
Tatlışen
A
.
Primary obstructive megaureter with giant ureteral stone: a case report
.
Case Rep Urol
.
2013
;
2013
:
198592
.
22.
Ashraf
SM
,
Raza
MH
,
Aziz
M
,
Maheshwari
V
.
A rare association of giant hydronephrosis and transitional cell carcinoma
.
J Indian Med Assoc
.
1991 Sep
;
89
(
9
):
277
.
23.
Ujike
T
,
Noda
Y
,
Oka
D
,
Takada
S
,
Fujimoto
N
,
Koide
T
,
.
Squamous cell carcinoma of the renal pelvis with giant hydronephrosis
.
Hinyokika Kiyo
.
2003 Dec
;
49
(
12
):
757
9
.
24.
Kimura
R
,
Koyama
K
,
Abe
H
.
A case of sarcomatoid renal cell carcinoma associated with giant hydronephrosis
.
Hinyokika Kiyo
.
2012 Aug
;
58
(
8
):
435
8
.
25.
Grasso
M
,
Caruso
RP
,
Phillips
CK
.
UPJ obstruction in the adult population: are crossing vessels significant
.
Rev Urol
.
2001 Winter
;
3
(
1
):
42
51
.
26.
Mountney
J
,
Chapple
CR
,
Johnson
AG
.
Giant hydronephrosis: a diagnostic dilemma
.
Urol Int
.
1998
;
61
(
2
):
121
3
.
27.
Hemal
AK
,
Aron
M
,
Wadhwa
SN
.
Nephroplication and nephropexy as an adjunct to primary surgery in the management of giant hydronephrosis
.
Br J Urol
.
1998 May
;
81
(
5
):
673
7
.
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