Obstructive uropathy due to inflammatory abdominal aortic aneurysm occurring 18 years after surgical repair of an atherosclerotic aneurysm

iliac fossa with no signs of peritonism. The abdominal film was unremarkable. Abdominal ultrasound showed an iliocolic intussusception (Figure 1). She remained clinically and biochemically nephrotic at this time. She entered the remission phase of nephrotic syndrome between Days 7 and 10 after the initiation of therapy which coincided with the complete resolution of her abdominal pain. Gastrointestinal disturbances are frequently encountered in the course of nephrotic syndrome. The differential diagnosis considered included renal vein thrombosis, peptic ulcer disease and subacute bowel obstruction. Fortuitously, at the time of ultrasonography, the patient developed an episode of colicky abdominal pain, and the intussusception could be demonstrated. Ultrasonography is the diagnostic tool of choice to detect intussusception, although it can be operator dependent or limited by body habitus. Intussusception causes ‘telescoping’ of the bowel due to a lead point in the bowel, which in this case is due to incoordinate gut motility and bowel wall oedema. Intussusception is not infrequently described in the paediatric literature, but the usual cause in adults is secondary to a bowel tumour, which acts as a lead point for the invagination of the bowel [2]. Treatment of the underlying nephrotic syndrome resulted in resolution of the intussusception without the need for any intervention [3,4]. Infusions of albumin have also been described [5]. We conclude that nephrologists should consider intussusception in the differential diagnosis of abdominal pain in the setting of nephrotic syndrome as early recognition may improve prognosis.