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Postoperative severe hydroureteronephrosis

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

History of total abdominal hysterectomy and bilateral salpingo-oophorectomy due to the left ovarian cancer. Work up for reported left sided hydronephrosis on follow up ultrasonography.

Patient Data

Age: 60 years
Gender: Female

Absent left urinary collecting system on IVU evaluation.

Severe hydroureteronephrosis with marked renal parenchymal atrophic changes are seen on the left side. No renal or ureteral stones are noted bilaterally.

Due to prior resection, the uterus and ovaries are not seen at the anatomical location. A 16×14 mm soft tissue density mass like lesion is noted at the distal of the left ureter that involves the left UVJ.

Multiple enlarged lymph nodes are seen at para aortocaval regions with SAD less than 20 mm. 

Case Discussion

The patient had a history of total abdominal hysterectomy and bilateral salpingo-oophorectomy due to left ovarian cancer. Work up for reported left sided hydronephrosis on follow up ultrasonography shows distal left ureteral infiltration. The patient underwent cystoscopy and biopsy of the distal of the left ureteral lesion, and histopathology evaluation confirmed post operation granulation tissue. 

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