Bilateral Renal Lymphangiectasia Resulting in Flank Pain, Acute Kidney Injury, and Page Kidney: A Case Report

A 22-year-old male presented with flank pain, hypertension, and acute kidney injury (AKI). Initial investigations revealed bilateral perinephric fluid collections with mass effect on the underlying renal cortices, suggestive of page kidney phenomenon. While initially suspected to be due to hematomas or urinomas, subsequent aspiration of the collections revealing serous fluid and retrograde pyelograms showing no extravasation of urine suggested a lymphatic etiology. The patient continued to experience bilateral flank pain and decreased kidney function despite conservative treatment. The patient underwent successful robotic bilateral capsulotomy, resulting in improved renal function and reduction of pain. This case highlights the importance of considering lymphatic anomalies in the differential diagnosis of perirenal fluid collections and the use of robotic-assisted laparoscopic bilateral capsulotomy as an effective surgical intervention when conservative measures are insufficient.

Keywords: Renal Lymphangiectasia, Robotic Capsulotomy, Page Kidney.