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Case report


Hydronephrosis as an unusual cause of acute pancreatitis.

Nata Pratama Hardjo LugitoEdy GunawanMargaret ChandraAndree Kurniawan
Department of Internal Medicine, Pelita Harapan University, Banten, Resident Medical Officer, Siloam Karawaci General Hospital, Tangerang, Indonesia
Date of Submission: 23-Mar-2015, Date of Acceptance: 05-Apr-2015, Date of Web Publication: 30-Apr-2015.
Corresponding Author:
Corresponding Author

Nata Pratama Hardjo Lugito

Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Jendral Sudirman Boulevard, Lippo Karawaci, Tangerang, Banten ‑ 15811, Indonesia.
E-mail: nata.lugito@uph.edu

Corresponding Author:
Corresponding Author

Nata Pratama Hardjo Lugito

Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Jendral Sudirman Boulevard, Lippo Karawaci, Tangerang, Banten ‑ 15811, Indonesia.
E-mail: nata.lugito@uph.edu

DOI: 10.4103/2156-7514.156123 Facebook Twitter Google Linkedin

ABSTRACT


Acute pancreatitis is an inflammatory disease of the pancreas. The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct (38%) and alcoholism (36%). There have been a few reports in the literature of acute pancreatitis associated with an obstructed urinary system. This case describes a 38-year-old male with acute pancreatitis occurring in the setting of hydronephrosis. A magnetic resonance cholangiopancreaticography (MRCP) showed right-sided severe hydronephrosis pushing the duodenum and head of pancreas anteriorly, thus obliterating distal segment of the common bile duct. There were also multiple right renal stones causing ureteral obstruction and hydronephrosis. Right nephrostomy was performed to release bile duct obstruction. However, sepsis and disseminated intravascular coagulation developed as a complication of acute pancreatitis, and the patient passed away. Although gallstone and alcoholism are the most common causes of acute pancreatitis, other causes should always be considered. Physicians should be aware of right hydronephrosis as one of the possible causes of acute pancreatitis in their workup of patients.
Keywords: Acute, Hydronephrosis, Pancreatitis

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