Clinical manifestation or incidental finding of
congenital kidney anomalies are more often discovered during pregnancy. Even if
the acute presentation (in the antenatal period, as in this case) precludes a
full diagnostic workup, assiduous follow-up and investigations in the postnatal
period will resolve the initial uncertainty. This is not a new phenomenon based
on literature and urologic differential diagnoses such as an ectopic urinary
system which should always be entertained and excluded prior to making the
diagnosis of an adnexal mass. We present a case of 33-year-old woman with
acute abdominal pain and a previous obstetric (mis)diagnosis of hydrosalpinx
(based on ultrasonography) made 8 years before presenting to the emergency
department with acute lower abdominal pain, fever, chills and rigors. Current
investigations revealed congenital abnormal kidneys bilaterally, with ectopic
left kidney and grossly infected hydronephrosis, which was likely the
fluid-filled mass initially mistaken for a hydrosalpinx. She then underwent
left nephrostomy and later had simple left nephrectomy. This case highlights
the importance of making an accurate diagnosis and arranging careful follow-up
of the female patient presenting with a “cystic” mass of the pelvic region during
pregnancy.
Cite this paper
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