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August 1962

Massive Hydronephrosis Simulating Ascites

Author Affiliations


Medical Services of Maimonides Hospital and Downstate Medical Center of the State Medical School of New York.; Resident in Medicine, Maimonides Hospital (Dr. Weil), and Assistant Clinical Professor, Department of Medicine, State University Medical School of New York and Associate Attending Physician, Maimonides Hospital (Dr. Rosenberg).

Arch Intern Med. 1962;110(2):237-239. doi:10.1001/archinte.1962.03620200097017

Introduction  Massive or giant hydronephrosis has been arbitrarily defined as a hydronephrosis containing at least 1,000 ml. of fluid.1 The condition, although unusual, is not rare.1,2 It is rare, however, for the hydronephrosis to attain such proportions that clinically it simulates ascites, as occurred in the patient presented in this report. Our purpose in describing this case is (1) to emphasize the possibility that massive hydronephrosis should be considered in all instances of ascites of obscure origin, (2) to delineate certain features suggestive of such massive hydronephrosis, and (3) to call attention to the dangers attendant upon misdiagnosis.

Report of a Case  A 28-year-old man was admitted to Maimonides Hospital on June 26, 1959, because of progressive abdominal swelling during the previous 8 months. At first, the patient had attributed his increased abdominal girth to obesity. By dieting, he lost about 20 lb. in weight, but his abdomen

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