Case Report on Left Pelvi-Ureteric Junction Obstruction with Left Hydroureteronephrosis

Pelvi-ureteric junction obstruction (PUJO) is the most common cause of congenital hydronephrosis and may lead to progressive renal damage if not appropriately managed. Infants undergoing surgical correction require careful postoperative surveillance, as complications may present with subtle and non-specific symptoms. We report the case of a 4-month-old male infant with antenatally detected left PUJO and hydroureteronephrosis who underwent multiple urological interventions, including DJ stenting, Anderson–Hynes pyeloplasty, and ultimately left nephrectomy. The child presented with persistent irritability aggravated by handling, without fever, vomiting, or reduced urine output. This presentation posed a diagnostic challenge, highlighting the importance of considering postoperative discomfort, stent-related morbidity, urinary tract infection, or evolving urological complications in non-verbal patients. This case underscores that irritability alone can be a significant clinical indicator in infants with complex PUJO management. A high index of suspicion, systematic evaluation, and structured follow-up are essential to ensure early detection of complications, optimize recovery, and improve long-term outcomes in obstructive uropathy.