Investigating the Abnormal Presentation of Ureteropelvic Junction Obstruction in Adolescence: A Case Report: Ureteropelvic Junction Obstruction in Adolescence

Abstract

Background and Aim: Ureteropelvic junction obstruction (UPJO) is a common cause ofhydronephrosis and is typically diagnosed antenatally. About 70% of these cases will selfresolve;however, symptomatic children may present with abdominal pain (i.e. Dietl crisis),vomiting, rash, or fever.Case Presentation: A 14-year-old male patient presented with cyclical vomiting every twomonths for the past two years. The patient’s mother also described an eight-year historyof headaches and intermittent abdominal pain. A renal magnetic resonance urographyscan revealed decreased right kidney function and delayed cortex to ureter transit time. Apyeloplasty and stent placement were performed to correct the obstructing vessel.Conclusion: Clinical guidelines for abdominal pain and cyclical vomiting earlier in thepatients’ healthcare may have led to an appropriate workup and treatment years before. Werecommend physicians consider UPJO as a differential diagnosis in adolescent patients withcyclical vomiting and abdominal pain and consult the North American Society for PediatricGastroenterology, Hepatology, and Nutrition (NASPGHN) guidelines to better guide thediagnosis