case_images: PMC10438974_01
case_images: (a) Dilated left pyelocaliceal system with no significant obstruction. (b) Intravenous pyelogram showed no significant obstruction on the left side. (c) Hydronephrosis with obstruction pattern on the left side. (d) Intravenous pyelogram showed significant obstruction on the left side. (e) A laparoscopic image showing an aberrant vessel. (f) Normal functioning with evidences of partial obstruction in the left side.
case_images: CRIU2023-6855975.001.jpg
case_images: PMC10438974_01_CRIU2023-6855975.001.jpg
case_images: fig1
case_images: After 7 years of surveillance and ruling out the vesicoureteral reflux, her symptoms got worsen during 6 months with remarkable changes in her imaging findings (Figures 1(c) and 1(d)). There was an aberrant vessel during laparoscopy, and after releasing and transpositioning this vessel, the left renal pelvis showed an ever-increasing dilation, which meant an intrinsic obstruction at UPJ may be responsible for the situation (Figure 1(e)). So, we performed dismembered pyeloplasty with no early complication, and after three months, she noted great relief in her symptoms, as well as that the follow-up DRG demonstrated obvious improvement in renal function (Figure 1(f)).