Böbrek kistleri çoðu zaman asemptomatik seyretse de bazen büyük boyutlara ulaþarak klinik bulgu verebilir. Bu olgu sunumunda, acil servise bulantý, kusma ve göbek deliði yakýnýnda þiþlik þikayetiyle gelen 78 yaþýnda bir erkek hasta sunulmaktadýr. Hasta diyabetes mellitus nedeniyle oral antidiyabetik (Metformin) kullanmaktaydý. Fizik muayenede umblikal bölgede yaklaþýk 5x5 santim boyutunda þiþlik, abdominal asimetri ve batýn sol yarýsýnda palpasyonla fluktuasyon veren kitlesel görünüm mevcuttu.Laboratuar bulgularý yükselmiþ beyaz küre ve serum kreatinin dýþýnda normaldi. Abdominal tomografi incelemesinde umblikal bölgede herni defekti ve bu defekt içerisine herniye olmuþ ince barsak anslarýnýn yaný sýra sol böbrekten kaynaklanan 28x30 santim, sað böbrekten kaynaklanan 15x 12 santim boyutunda kist mevcuttu. Sigmoid kolon çapý ileri derecede incelmiþti. Hasta operasyona alýnarak bilateral böbrek kistlerine deroofing uygulandý. Kistlerin içerisinden yaklaþýk 15 litre sývý aspire edildi. Herni defekti mesh ile onarýldý.Hasta postoperatif 6. gün komplikasyonsuz þekilde taburcu edildi. Bu vaka, dev böbrek kistlerinin baðýrsak týkanýklýðýný tetikleme potansiyelini ve abdominal semptomlarla baþvuran hastalarda bu etiyolojinin göz önünde bulundurulmasý gerekliliðini vurgulamaktadýr. Bilgisayarlý tomografi, ultrason muayenesi ve manyetik rezonans gibi görüntüleme yöntemleri böbrek kistlerini ve potansiyel komplikasyonlarýný tanýmak için büyük öneme sahiptir. Terapötik yaklaþýmlar arasýnda perkütan aspirasyon, skleroterapi, laparoskopik deroofing ve önemli komplikasyonlarýn veya büyük kistlerin olduðu durumlarda cerrahi müdahale yer almaktadýr.

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

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.