Intermittent hydronephrosis as a cause of abdominal pain

THE PAIN of intermittent hydronephrosis, also known as Dietl's crisis, may mimic almost any intra-abdominal disease, and it is not unusual for these patients to have undergone appendectomy, cholecystectomy, or exploratory celiotomy before the true etiology of their pain is discovered. The fact that some kidneys are more mobile than others has been known for centuries. Abdominal or flank pain, often associated with nausea and vomiting, was occasionally seen in these patients with ptotic kidneys, but it was Dietl's masterly written description of the syndrome, in 1864, that gave it its name. While some physicians felt that the ptotic kidney was a benign condition, others were equally convinced it could precipitate severe pain. That the latter was a popular view is attested to by the large number of nephropexies done at the turn of the century and for several years thereafter. As recently as 1930, the literature has been replete