Bowel Obstruction Unveiling the Hidden Burden of Polycystic Kidney Disease: A Case Report

Polycystic Kidney Disease (PKD), particularly Autosomal Dominant Polycystic Kidney Disease (ADPKD), is a genetic disorder that can lead to kidney enlargement and, ultimately, End-Stage Renal Disease (ESRD). The enlargement of these cysts can exert pressure on adjacent structures, including the gastrointestinal tract, which can lead to a range of gastrointestinal complications, including bowel obstruction. We describe the presentation of a 58-year-old male with Chronic Kidney Disease (CKD), hypertension, anaemia, and hepatitis B, who developed symptoms of weakness, somnolence, vomiting, and anorexia. Upon examination, the patient exhibited signs of dehydration and altered mental status without acute abdominal pain. Blood tests revealed worsening renal function, electrolyte imbalances, and anaemia. Imaging demonstrated significant intestinal distension due to mechanical obstruction, most likely caused by compression from large cysts associated with ADPKD. The patient was managed with fluid and electrolyte replacement, continuous dialysis, and monitoring of mental status. An interventional radiology procedure was performed to relieve the obstruction through percutaneous pigtail drainage of the right lower pole cyst. A surgical consultation was sought for potential intervention. This case report highlights the often-overlooked gastrointestinal complications of ADPKD, emphasising bowel obstruction as a hidden burden of the disease and the importance of early diagnosis and a multidisciplinary approach to prevent the deterioration of the patient’s condition.