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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
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[Intermittent hydronephrosis in childhood]
Miklós Merksz1, Bálint Sulya, Mária Polovitzer
1Heim Pál Gyermekkórház, Urológiai Sebészeti Osztály, Budapest. merksz@heimpalkorhaz.hu
Orvosi Hetilap
|June 12, 2013
Summary
Intermittent hydronephrosis is challenging to diagnose, often leading to delayed treatment. Early recognition of this condition in children with recurrent abdominal pain is crucial to prevent kidney loss.
Area of Science:
- Pediatric Urology
- Diagnostic Challenges in Nephrology
Background:
- Intermittent pelviureteric junction obstruction causes hydronephrosis, which is difficult to diagnose due to non-dilated collecting systems between pain episodes.
- Prompt investigation during painful crises is challenging, leading to initial misdiagnosis in many pediatric cases.
Observation:
- A study reviewed medical records of children operated for hydronephrosis between 2008-2012.
- 10 out of 76 children operated for pelviureteric junction obstruction met criteria for intermittent hydronephrosis.
Findings:
- The average diagnostic delay for intermittent hydronephrosis was 2 years and 4 months.
- Pyeloplasty was performed in 7 patients, while 3 patients required nephrectomy due to the condition.
Implications:
- Intermittent hydronephrosis constitutes a significant proportion of surgically treated hydronephrosis cases.
- Delayed diagnosis resulted in kidney loss in one-third of affected children, highlighting the need for increased clinician awareness.
- Recurrent, unexplained abdominal pain in children should prompt suspicion of urological issues, even with normal initial ultrasounds.
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