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The relationship of age to pathology in pelviureteric junction obstruction
P A Dewan1, K P Ng, P J Ashwood
1Department of Surgery, Royal Children's Hospital, Victoria, Australia.
Objective:
To ascertain the age distribution of the different pathological mechanisms which lead to the development of pelviureteric junction obstruction.
Methods:
A series of 165 kidneys in 158 children who underwent pyeloplasty for pelviureteric junction obstruction were reviewed. Those 132 renal units (127 children) with uncomplicated pathology were selected for further study. The operative records were reviewed for the underlying cause of obstruction and the age at operation.
Results:
Obstruction due to extrinsic compression by an aberrant lower pole vessel occurred in an older group (median age 67.3 mo) than those with a narrowing or angulation of the pelviureteric junction (median age 3.1 mo).
Conclusions:
Pelviureteric junction obstruction, secondary to a lower pole vessel presents at an older age. Doppler ultrasonography to detect a lower pole vessel may be of benefit in the management of equivocal cases of pelviureteric junction obstruction, particularly in prenatally diagnosed hydronephrosis.