Massive simple renal cyst causing colonic obstruction: the largest documented case in the literature.

Abstract

Simple renal cysts are often asymptomatic, but they can sometimes cause clinical signs when they reach a large size. In this report, we present the case of 78 a old male patient who visited the emergency department with symptoms such as nausea, vomiting, and abdominal swelling near the belly button. The patient had diabetes mellitus, which was regulated by metformin. Physical examination revealed a 5 × 5 cm umbilical swelling, abdominal asymmetry, and palpable fluctuations on the left side of the abdomen. Laboratory assessments indicated elevated white blood cell count and creatinine levels. An abdominal computed tomography scan indicated herniated segments of the small intestine emerging from the umbilical zone and a partial obstruction in the sigmoid colon, resulting from a cyst measuring 28 × 30 cm in the left kidney and a 15 × 12 cm cyst in the right kidney, and the sigmoid colon was progressively thinner in diameter. The patient underwent a surgical procedure involving unroofing of the bilateral cyst wall, aspiration of 15 liters of fluid, and mesh repair of the umbilical hernia. Discharge occurred on postoperative day six, and no complications were noted. This case highlights the potential of giant renal cysts to precipitate intestinal obstruction, and the need to consider this etiology in patients presenting with abdominal symptoms. Methods such as computed tomography, ultrasound, and magnetic resonance imaging are vital for recognizing and analyzing renal cysts and their potential complications. Therapeutic approaches include percutaneous aspiration, sclerotherapy, laparoscopic deroofing, and surgical intervention in cases with significant complications or large cysts.