Managing Pyeloureteral Atresia in Pediatrics: A Case of Right-Sided Hydronephrosis and Surgical Intervention.

BACKGROUND Pyeloureteral atresia is a rare congenital anomaly characterized by complete obstruction of the ureteropelvic junction, leading to severe hydronephrosis and potential renal damage. Early diagnosis and surgical intervention are essential to preserve renal function and prevent long-term complications. CASE REPORT A 3-year-old boy presented with a 3-day history of worsening abdominal pain, nausea, and vomiting. Physical examination revealed abdominal tenderness, primarily in the right lower quadrant. Notably, there were no genitourinary symptoms such as dysuria, hematuria, or changes in urinary frequency. Laboratory tests indicated mild leukocytosis and elevated serum creatinine, suggesting impaired renal function. Abdominal ultrasound revealed massive right-sided hydronephrosis, which was further evaluated by contrast-enhanced CT, confirming an atretic segment at the ureteropelvic junction consistent with pyeloureteral atresia. The child underwent right-sided pyeloplasty, involving resection of the atretic segment and reconstruction of the ureteropelvic junction to restore urinary flow. Recovery was smooth, with renal function normalizing within 1 week. A follow-up ultrasound at 2 weeks after surgery confirmed the resolution of hydronephrosis. He was scheduled for regular follow-ups to monitor renal health. CONCLUSIONS This case shows the importance of early recognition and management of pyeloureteral atresia in pediatric patients. Comprehensive imaging, detailed surgical intervention, and timely management can optimize outcomes, preserving renal function and ensuring long-term health. Continued awareness and research are necessary to improve diagnosis and treatment strategies for this rare congenital anomaly.