1.   An unusual case of bilateral ureteric obstruction and hydronephrosis due to pancreatic pseudocyst formation, after an episode of acute pancreatitis is reported.

2.   Pancreatic pseudocysts are localised collections of pancreatic secretions occurring as a result of pancreatic inflammation and ductal disruption.

3.   Pancreatic pseudocysts extend along the fascial planes, following the line of least resistance and may extend from the mediastinum to the groin.

4.   A fistula between a pancreatic pseudocyst and the left renal pelvis has been reported, as has a left pancreatic perirenal fistula.

5.   There is controversy about the management of pancreatic pseudocysts.

6.   In summary, we report a case of a retroperitoneal pancreatic pseudocyst causing distal bilateral ureteric obstruction and bilateral hydronephrosis.