Related Experiment Videos
[Lithiasis in horseshoe kidney in children. Apropos of 6 cases]
Insights
Pediatric stones in horseshoe kidneys often present with complications like infection and obstruction, requiring careful diagnosis and surgical management. Open surgery remains common due to challenges with newer techniques in this specific congenital malformation.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Oncology
Context:
- Horseshoe kidney is a congenital anomaly associated with an increased risk of urolithiasis.
- Diagnosis of stones in horseshoe kidneys in children is often delayed until complications arise.
- Associated urological malformations, such as vesicoureteral reflux and ureteropelvic junction obstruction, are common.
Purpose:
- To analyze the diagnostic and surgical challenges of treating stones in children with horseshoe kidneys.
- To review the management strategies for pediatric urolithiasis in the context of horseshoe kidney malformation.
- To highlight the complexities of surgical intervention in this patient population.
Summary:
- This case report details the diagnosis and surgical management of six children (25 months to 14 years old) with stones in horseshoe kidneys.
- Diagnosis was often prompted by complications, including severe septic obstruction.
- Pre- and intra-operative sonography aided stone localization.
- Open surgery was the primary treatment modality due to difficulties and risks associated with extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy in this malformation.
- Multiple surgical procedures may be necessary to address both the stones and associated anomalies like ureteropelvic junction obstruction, especially with infectious complications.
Impact:
- This study underscores the need for vigilant monitoring and tailored surgical approaches for pediatric patients with horseshoe kidneys and urolithiasis.
- It emphasizes the current limitations of minimally invasive techniques in this complex pediatric population.
- Findings can inform clinical decision-making and guide future research into optimizing treatment outcomes for these challenging cases.
Abstract:
In a 6 cases report of stones developed in horseshoe kidney in children, from 25 months old to 14 years old, diagnosis and surgical problems are analysed. Another urological malformations have to be researched mainly vesico renal reflux and pyelo ureteric junction obstruction. Diagnosis is usually made when stones give complications where septic obstruction is not rare and can be severe in children. Pre and intra-operative sonography can currently do the stone localisation. Surgical management of stones developed in horseshoe kidney seems to be done still by open surgery because new techniques as Eswl or percutaneous lithotripsy can be difficult to perform or dangerous in children on this malformation. Number of operations can often be higher than in adults, to do both treatment of the stone and associated malformation as PUJ obstruction, mainly if there are infected and septic complications.