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False uroradiologic pathology in children with urinary tract infection and fecal impaction
1Department of Diagnostic Radiology, Rambam Medical Center, Haifa, Israel.
Insights
Fecal impaction in children can mimic urinary tract abnormalities on intravenous pyelography (IVP). Prompt bowel cleansing during IVP can reveal normal uroradiologic findings, suggesting caution when interpreting results in impacted patients.
Area of Science:
- Pediatric Radiology
- Urology
- Gastroenterology
Background:
- Urinary tract infections (UTIs) in children can present with various uroradiologic abnormalities.
- Fecal impaction is a common condition in children, though not always associated with constipation history.
- The potential for fecal impaction to influence radiologic findings in pediatric urinary tract evaluations is not fully understood.
Abstract:
Intravenous pyelography (IVP) in 5 children with urinary tract infection detected various uroradiologic abnormalities. Despite the lack of history of constipation, a common denominator to all 5 patients was the finding of fecal impaction in the rectosigmoid. In the first 3 patients, repeated complete IVP series done several weeks later and after preparatory bowel enema were normal. In the last 2 patients, the radiologic investigation was interrupted when the first exposure disclosed uroradiologic abnormalities and fecal impaction. Following immediate bowel enema, the studies were completed on the same settings to be found normal. It is concluded that in the face of fecal impaction, pathologic uroradiologic findings should be interpreted with great caution. Moreover, in such cases, intraprocedure cleansing enema is feasible and recommended.