Vadodara: A 58-year-old woman from the city suffering from Autosomal Dominant Polycystic Kidney Disease (ADPKD), a rare inherited kidney disorder, was saved after doctors in a city hospital performed emergency surgery to remove her right kidney.Doctors at city’s Sterling Hospital who performed the technically challenging surgery, said the removed kidney weighed an astonishing 2.035 kg, almost 10 times heavier than a normal adult kidney.The woman was admitted with massive haematuria, or blood in the urine, resulting in severe blood loss. Her haemoglobin levels dropped to a critical 5g/dL, prompting doctors to administer repeated blood transfusions, supportive treatment and continuous monitoring.A CT renal angiogram revealed that both kidneys were significantly enlarged and contained multiple haemorrhagic cysts. The right kidney was identified as the main source of the persistent bleeding.Although the kidney had not ruptured, continuous bleeding from the cysts caused ongoing blood loss, with her haemoglobin continuing to fall despite aggressive medical management.A multidisciplinary team comprising nephrologists, physicians, anaesthesiologists, intensivists, surgeons and operation theatre specialists concluded that an emergency right nephrectomy was the only viable option to control the bleeding and save the patient’s life.The surgery was performed last month and lasted nearly two hours. The procedure successfully stopped the bleeding without any intraoperative complications. The massive size was attributed to extensive cystic enlargement caused by ADPKD.The patient was monitored and treated in intensive care following the surgery and gradually recovered. She was discharged recently.Dr Sagar Joshi, urologist, laparoscopic and transplant surgeon at Sterling Hospital, said the case was particularly challenging because of the persistent, life-threatening bleeding from multiple haemorrhagic cysts.“Emergency nephrectomy became the only viable option after medical treatment failed to control the bleeding. Despite the complexity caused by the massively enlarged kidney and ongoing blood loss, the surgery was successfully completed“, said Dr Joshi.The case highlights the importance of timely surgical intervention and close multidisciplinary coordination in managing rare and potentially life-threatening complications of polycystic kidney disease.
