Gross hematuria associated with congenital hydronephrosis

Congenital Hydronephrosis is one of the most common congenital anomalies in children. The presentation of congenital hydronephrosis has shifted from postnatal to antenatal. Postnatally it is commonly asymptomatic and usually detected as an incidental mass. The child may also present with abdominal pain, urinary infection and stones. Rarely, the child may have hematuria and hypertension. We report one such rare case in which the child has episode of gross frank hematuria, hypertension and impending hypovolemic shock. We also elaborate about the resuscitation and next steps of management in our case. •Congenital Hydronephrosis is one of the most common congenital anomalies in children.•The most common form of presentation is incidental detection of lump, followed by urinary tract infection.•Rarely, a child may present with hematuria and hypertension.