A Rare Clinic Presentation of Polycystic Kidney Disease

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Kaya M., Kadıoğlu E., Aydın H., Çoşkun A., Yıldırım H.

2nd Southeast European Congress of Emergency and Disaster Medicine 20 - 22 July 2019 İstanbul, İstanbul, Turkey, 20 - 22 June 2019, pp.114

  • Publication Type: Conference Paper / Summary Text
  • City: İstanbul
  • Country: Turkey
  • Page Numbers: pp.114
  • Kütahya Health Sciences University Affiliated: Yes


Introduction Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a multisystemic disorder characterized by multiple cysts in both kidneys (1.) Even though age-related non-genetic renal cysts with normal renal function are seen, bilateral multiple renal cysts should suggest an underlying hereditary disease (2). Clinically, renal blood flow reduction as a result of kidney enlargement, urinary system or cyst infections, hematuria, hemorrhage, nephrolithiasis and end-organ damage as a result of hypertension is seen. Major non-renal complications are a cerebral aneurysm, hepatic and pancreatic cysts, cardiac valve diseases, colonic diverticulum, inguinal hernia(3). In addition, the incidence of cancer increases in these patients (4). In our case, we presented the clinical picture of renal cysts causing choledochal canal and gallbladder compression. Case A 68-year-old man was admitted to our emergency department with nausea, vomiting and abdominal pain. The arterial blood pressure was 130/80 mmHg, pulse 78 beats/min. and no fever. He had been by-pass 17 years ago and had rectal cancer surgery 7 months ago. On physical examination, there was only mild tenderness and distension in the right upper quadrant and epigastric region. Laboratory Tests: Wbc:17.9 103 /L, Hemoglobin:11.6g/dL, Urea:92 mg/dL, creatinine:1.59mg/dL, sodium (Na):123 mmol/L, potassium:4.3mmol/L, C-reactive protein: 218 mg/L, aspartate aminotransferase:59U/L, alanine aminotransferase:117 U/L, amylase:79 U/L, lipase: 13 U/L, gamma-glutamyl transferase:148 U/L, total bilirubin:1.53mg/dL, direct bilirubin:1.03 mg/dL, glucose:107 mg/dl. Abdominal ultrasonography revealed normal and multiple renal cysts. In abdominal tomography, cysts are seen to compress the gallbladder and bile duct (Figure 1). After the patient was consulted to the urology specialist, he was hospitalized for further examination and treatment. Conclusion The patients with polycystic kidney disease may also mimic acute cholecystitis due to the big size of the cysts. So, these patients should be closely monitored due to their complications. Computed tomography scan showing the compression of renal cysts into the gallbladder Keywords: Polycystic Kidney Disease; Abdominal pain; Cholecystitis