Related Experiment Videos
[Renal upper pole calyceal obstruction: clinical and radiological significance (author's transl)]
Insights
Intrarenal vascular compression can obstruct superior renal calyces, causing hematuria in children. Early investigation for calyceal obstruction is recommended for idiopathic hematuria, with long-term follow-up for potential complications.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Urology
Background:
- Intrarenal vascular compressions can lead to superior renal calyceal obstruction.
- This obstruction may present as a filling defect on imaging and prolonged retention on renography.
- Clinical presentation can include recurrent hematuria or urinary tract infections.
Purpose of the Study:
- To investigate the clinical significance of superior renal calyceal obstruction due to intrarenal vascular compression.
- To correlate imaging findings with clinical symptoms and renal function.
- To evaluate the necessity of intervention and long-term follow-up.
Main Methods:
- Retrospective analysis of 23 pediatric patients with suspected calyceal obstruction.
- Characteristic imaging findings (filling defect, blunting of fornices) were assessed.
- Scintillation camera renography was used to evaluate renal collecting system function.
Main Results:
- 11 of 23 children presented with recurrent hematuria; other causes were excluded.
- 5 patients had urinary tract infections; 7 had normal urinary findings.
- Renal function remained normal in all patients, with no correlation between blunting severity and hematuria.
Conclusions:
- Superior renal calyceal obstruction should be investigated in cases of idiopathic hematuria.
- Even without fornix blunting, clinical symptoms can be present.
- Uncomplicated cases do not require immediate therapy but necessitate long-term follow-up for complications like UTIs and urolithiasis.
Abstract:
Obstruction of the superior renal calyces due to intrarenal vascular compressions is assumed on the basis of a characteristic sharply defined oblique filling defect with or without blunting of the fornices. Scintillation camera renography shows prolonged retention in the superior collecting system of the involved kidney. 11 out of 23 children had a symptomatology of recurrent hematuria, other origins of hematuria were excluded. 5 patients had urinary tract infection, the remaining 7 had normal urinary findings. Renal function was always normal. There is no correlation between severity of blunting and hematuria. In contrast to other studies which included only patients with blunting and ectasis even cases without blunting of the fornices have a clinical symptomatology. Deterioration of radiologic appearance and kidney function was not found. Any idiopathic hematuria should be investigated for calyceal obstruction. Uncomplicated cases require no therapy, long term follow-ups with regard to complications such as urinary tract infection and urolithiasis are indicated.