An Unusual Complication of Ureteral Stone: Massive Gastric Dilatation and Duodenal Obstruction Due to Giant Hydronephrosis

A 42 year old man, was admitted to emergency service who suffered from nausea and vomitting for two days. In his physical examination the right side abdomen was severe distended, that had been lasting for a month. Distension was tender and cystic tough mass lesion was palbable. Plain abdominal radiography showed a 3 cm radiopaque shadow in the pelvic area. Ct scan revealed massive gastric dilatation and duodenal obstruction due to giant hydronephrosis with the ureteric stone placing on the right lower ureter with a dimension of 3,5 to 3 cm. Nasogastrical decompression and right percutaneus nephrostomy catheter was performed, 5000 ml of gastric fluid and 5300 ml of nephrostomy catheter drainage was measured in the first six hours. 99m Tc-dimercaptosuccinic acid (DMSA) scan showed non-functioning right kidney and the patient finally underwent open simple nephroureterectomy. To the best of our knowledge the present patient represents one of the rarest complication of giant hydronephrosis cases reported to date.