Laparoscopic management of pelvi-ureteric junction obstruction caused by aberrant renal vessels in an adult

Pelvi-ureteric junction obstruction (PUJO) is not a rare clinical entity. It is indeed one of the common urological conditions presenting most commonly with hydronephrosis and pain. The most common etiology for patients suffering from acquired PUJO is the presence of calculus/calculi. An aberrant renal vessel (now termed as a vascular bar) is one of the causes in adults which are often missed on pre-operative investigations and is detected intraoperatively. We present herein the case of a 28 years old female who came with complaints of loin pain for 2 – 3 months. The workup investigations revealed only hydronephrosis without any calculi. Thus, a diagnosis of the primary PUJO was made. The patient was successfully managed by a laparoscopic pyeloplasty.

Wilkie’s syndrome: Laparoscopic management – A case report with review of the literature

Superior mesenteric artery (SMA) syndrome also known as Wilkie’s Syndrome is a rare condition characterized by symptoms of small bowel obstruction. It is caused when the angle between the SMA and aorta, also known as the aorto-mesenteric angle, reduces to <25° which, in turn, causes the compression of the third part of the duodenum which traverses between the SMA and the aorta. We, herein, present the case of a 31-year-old female who was diagnosed to have Wilkie’s syndrome. Failing a trial of conservative management, she was ultimately definitively managed by surgery.