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Kim SM, Lee SH, Park GY, Kim SS, Lee CG, Jin SJ. Cecal duplication cyst in an infant presenting as shock: A case report. World J Clin Cases 2023; 11:6931-6937. [PMID: 37901014 PMCID: PMC10600866 DOI: 10.12998/wjcc.v11.i28.6931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Although intestinal obstruction is one of the most common surgical emergencies in an infant, it is difficult to diagnose neonatal enteric duplication cysts (EDC) preoperatively owing to their rarity as a cause of intestinal obstruction. We describe a case report of a neonatal EDC presenting intestinal obstruction and shock. CASE SUMMARY A 32-d-old male infant with a prenatal sonographic finding of bladder distension was admitted to our hospital for a severely distended abdomen, fever, and oliguria. The first diagnostic hypothesis was septic shock and intestinal obstruction. The patient's symptoms worsened; following an emergency surgical exploratory laparotomy and histopathological findings, the final diagnosis of cecal duplication cyst was confirmed. The patient's postoperative course was uneventful, and on the fifth postoperative day, oral feeding restarted. Twenty days later, the patient was discharged from the hospital. CONCLUSION Although EDC located in the cecum is exceptional, it should be considered when evaluating suspected intestinal obstruction and shock.
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Affiliation(s)
- Seung Mo Kim
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soochunhyang University College of Medicine, Bucheon 14584, Gyeonggi-do, South Korea
| | - Sun Hyang Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soochunhyang University College of Medicine, Bucheon 14584, Gyeonggi-do, South Korea
| | - Ga Young Park
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soochunhyang University College of Medicine, Bucheon 14584, Gyeonggi-do, South Korea
| | - Sung Shin Kim
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soochunhyang University College of Medicine, Bucheon 14584, Gyeonggi-do, South Korea
| | - Cheol Gu Lee
- Department of General Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, GyeongGi-Do, South Korea
| | - Soo Ji Jin
- Department of Pathology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, GyeongGi-Do, South Korea
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Malone PS. Antenatal Diagnosis of Renal Tract Anomalies: Has it Increased the Sum of Human Happiness? J R Soc Med 2018; 89:155P-8P. [PMID: 8683521 PMCID: PMC1295702 DOI: 10.1177/014107689608900312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
When used as a screening procedure, ultrasound examination of the fetal urinary tract seldom leads to beneficial interventions. There is also a cost in terms of parental anxiety and unnecessary investigation and treatment. A formal screening programme would therefore be unjustified. However, screening of women for obstetric purposes will continue to reveal fetal abnormalities, and a strategy for dealing with these is needed. Antenatal treatments remain experimental; for most of the common conditions postnatal treatment has no urgency; and, in cases of minor abnormality detected by ultrasound, the best course may be to do nothing.
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Affiliation(s)
- P S Malone
- Department of Paediatric Nephrourology, Southampton General Hospital, England
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Abstract
UNLABELLED Fetal megacystis is variably defined and understood. The literature on fetal megacystis was systematically reviewed, focusing on prenatal diagnosis, associations and outcomes. This yielded a total of 18 primary references and eight secondary references. Fetal megacystis has an estimated first-trimester prevalence of between 1:330 and 1:1670, with a male to female ratio of 8:1. In the first trimester, megacystis is most commonly defined as a longitudinal bladder dimension of ≥7 mm. Later in pregnancy, a sagittal dimension (in mm) greater than gestational age (in weeks) + 12 is often accepted. Megacystis can be associated with a thickened bladder wall, which has been objectively defined as >3 mm. Oligohydramnios is present in approximately half of all cases. The most common underlying diagnosis is posterior urethral valves (57%), followed by urethral atresia/stenosis (7%), prune belly syndrome (4%), megacystis-microcolon-intestinal-hypoperistalsis syndrome (MMIHS) (1%), and cloacal anomalies (0.7%). Karyotype anomalies are found in 15%, and include trisomy 18, trisomy 13 and trisomy 21. Ultrasound imaging alone is often insufficient to enable a definitive diagnosis, although it may indicate that a specific diagnosis is more likely. Overall, about 50% of reported fetuses with megacystis are terminated, but this proportion varies considerably between countries and over time. Prognostic stratification is evolving, with the most important factors being oligohydramnios, gestational age at diagnosis, degree of bladder enlargement, renal hyperechogenicity, karyotype, and sex. CONCLUSIONS This review demonstrated some consensus on the ultrasound criteria for defining fetal megacystis, and illustrated the spectrum of pathologies and their relative frequencies that can cause this condition. It also underlined important associated karyotype anomalies. To progress understanding of the natural history of enlarged fetal bladders, more accurate diagnostics are required, and risk stratification needs to be refined to facilitate prenatal counseling.
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Chitrit Y, Bourdon M, Korb D, Grapin-Dagorno C, Joinau-Zoulovits F, Vuillard E, Paye-Jaouen A, Peycelon M, Belarbi N, Delezoide AL, Schmitz T, El Ghoneimi A, Sibony O, Oury JF. Posterior urethral valves and vesicoureteral reflux: can prenatal ultrasonography distinguish between these two conditions in male fetuses? Prenat Diagn 2016; 36:831-7. [DOI: 10.1002/pd.4868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 06/20/2016] [Accepted: 06/26/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Yvon Chitrit
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
| | - Mathilde Bourdon
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
| | - Diane Korb
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
| | | | | | - Edith Vuillard
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
| | - Annabel Paye-Jaouen
- Department of Pediatric Urology and Surgery; Hôpital Robert Debré AP-HP; Paris France
| | - Matthieu Peycelon
- Department of Pediatric Urology and Surgery; Hôpital Robert Debré AP-HP; Paris France
| | - Nadia Belarbi
- Department of Pediatric Imaging; Hôpital Robert Debré AP-HP; Paris France
| | - Anne-Lyse Delezoide
- Department of Developmental Biology; Hôpital Robert Debré AP-HP; Paris France
| | - Thomas Schmitz
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
| | - Alaa El Ghoneimi
- Department of Pediatric Urology and Surgery; Hôpital Robert Debré AP-HP; Paris France
| | - Olivier Sibony
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
| | - Jean-François Oury
- Department of Obstetrics and Gynecology; Hôpital Robert Debré AP-HP; Paris France
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Calvo-Garcia MA. Imaging Evaluation of Fetal Megacystis: How Can Magnetic Resonance Imaging Help? Semin Ultrasound CT MR 2015; 36:537-49. [PMID: 26614135 DOI: 10.1053/j.sult.2015.05.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Evaluation of the kidneys, bladder, and amniotic fluid volume forms part of any standard obstetrical ultrasound. When a fetal genitourinary anomaly is suspected, a more detailed evaluation is necessary. This detailed imaging can be challenging in the setting of decreased or absent amniotic fluid or large maternal body habitus, and in complex malformations. In these situations, magnetic resonance imaging can help to better define the fetal anatomy and provide a more confident and specific prenatal diagnosis.
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Affiliation(s)
- Maria A Calvo-Garcia
- Department of Radiology, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH.
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Beke A, Eros FR, Pete B, Szabo I, Gorbe E, Rigo J. Efficacy of prenatal ultrasonography in diagnosing urogenital developmental anomalies in newborns. BMC Pregnancy Childbirth 2014; 14:82. [PMID: 24564681 PMCID: PMC3936834 DOI: 10.1186/1471-2393-14-82] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Showing a prevalence rate of 0.5-0.8%, urogenital malformations discovered in newborns is regarded relatively common. The aim of this study is to examine the efficacy of ultrasound diagnostics in detecting developmental disorders in the urogenital system. METHODS We have processed the prenatal sonographic and postnatal clinical details of 175 urogenital abnormalities in 140 newborns delivered with urogenital malformation according to EUROCAT recommendations over a 5-year period between 2006 and 2010. The patients were divided into three groups; Group 1: prenatal sonography and postnatal examinations yielded fully identical results. Group 2: postnatally detected urogenital changes were partially discovered in prenatal investigations. Group 3: prenatal sonography failed to detect the urogenital malformation identified in postnatal examinations. Urogenital changes representing part of certain multiple disorders associated with chromosomal aberration were investigated separately. RESULTS Prenatal sonographic diagnosis and postnatal results completely coincided in 45%, i.e. 63/140 of cases in newborns delivered with urogenital developmental disorders. In 34/140 cases (24%), discovery was partial, while in 43/140 patients (31%), no urogenital malformation was detected prenatally. No associated malformations were observed in 108 cases, in 57 of which (53%), the results of prenatal ultrasonography and postnatal examinations showed complete coincidence. Prenatally, urogenital changes were found in 11 patients (10%), whereas no urogenital disorders were diagnosed in 40 cases (37%) by investigations prior to birth. Urogenital disorders were found to represent part of multiple malformations in a total of 28 cases as follows: prenatal diagnosis of urogenital malformation and the findings of postnatal examinations completely coincided in three patients (11%), partial coincidence was found in 22 newborns (79%) and in another three patients (11%), the disorder was not detected prenatally. In four newborns, chromosomal aberration was associated with the urogenital disorder; 45,X karyotype was detected in two patients, trisomy 9 and trisomy 18 were found in one case each. CONCLUSION In approximately half of the cases, postnatally diagnosed abnormalities coincided with the prenatally discovered fetal urogenital developmental disorders. The results have confirmed that ultrasonography plays an important role in diagnosing urogenital malformations but it fails to detect all of the urogenital developmental abnormalities.
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Affiliation(s)
- Artur Beke
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Baross u, 27,, 1088 Budapest, Hungary.
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Terayama H, Yi SQ, Hirai S, Qu N, Naito M, Hatayama N, Kawata S, Itoh M. Gross anatomical study of bilateral megaureters associated with renal pelvis dilatation and a giant urinary bladder: an adult cadaver with a brief review of the literature. Anat Sci Int 2013; 88:171-4. [PMID: 23436237 DOI: 10.1007/s12565-013-0172-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 02/07/2013] [Indexed: 10/27/2022]
Abstract
Although bilateral megaureters are not an infrequent occurrence in the urinary tract, bilateral megaureters associated with bilateral renal pelvis dilatation and a giant urinary bladder appear to be rare. In this paper, a cadaver case of an adult Japanese male with bilateral megaureters is described. In addition to describing and illustrating this case, the anatomy and etiology of these anomalous structures is discussed with a brief review of the literature.
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Affiliation(s)
- Hayato Terayama
- Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
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Fujinaga S, Hirano D, Nishizaki N, Kanai H, Ohtomo Y, Kaneko K, Shimizu T. Unfavorable outcome in a child with megaureter-megacystis syndrome complicated by mild acute poststreptococcal glomerulonephritis. Pediatr Int 2010; 52:895-6. [PMID: 21166952 DOI: 10.1111/j.1442-200x.2010.03272.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Antenatal sonography has markedly increased the detection of urogenital anomalies, including those conditions that lead to significant morbidity and mortality. Prenatal intervention is feasible to arrest and sometimes reverse the sequelae of bladder outlet obstruction but not necessarily renal damage. Myelomeningoceles, the most severe form of spina bifida, can be corrected in utero, with improvements in hydrocephalus seen along with a decreased incidence of ventricular shunting postnatally. Medical therapy to prevent virilization associated with congenital adrenal hyperplasia has been successful, with improved ability to detect its presence prenatally now possible. As further techniques evolve to correct underlying disease processes, it becomes important to critically assess the therapies, particularly with long-term outcome data.
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Affiliation(s)
- Michael C Carr
- Division of Urology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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Abstract
Antenatal sonography has increased the detection of urogenital anomalies markedly, including conditions that lead to significant morbidity and mortality. Prenatal intervention is feasible to arrest and sometimes reverse the sequelae of bladder-outlet obstruction, but not necessarily renal damage. Myelomeningoceles, the most severe form of spina bifida,can be corrected in utero, with improvements in hydrocephalus and a decreased incidence of ventricular shunting postnatally. Medical therapy to prevent virilization associated with congenital adrenal hyperplasia has been successful, with improved ability to detect its presence prenatally. As techniques evolve to correct underlying disease processes,it becomes important to assess the therapies critically, particularly with long-term outcome data.
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Affiliation(s)
- Michael C Carr
- Division of Urology, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, 3rd Floor, Wood Building, Philadelphia, PA 19104-4399, USA.
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12
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Affiliation(s)
- R L Lebowitz
- Department of Radiology, Children's Hospital, Boston, Harvard Medical School, Boston MA 02115, USA.
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Pinette MG, Blackstone J, Wax JR, Cartin A. Enlarged fetal bladder: Differential diagnosis and outcomes. JOURNAL OF CLINICAL ULTRASOUND : JCU 2003; 31:328-334. [PMID: 12811794 DOI: 10.1002/jcu.10179] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The sonographic finding of an enlarged fetal bladder may simply be a transitory normal variant, but it may also be secondary to reflux or to obstructive, neurogenic, or myopathic causes. In this report, we describe the cases of 3 fetuses with an enlarged bladder, each of which had a different cause. The first fetus had posterior urethral valve obstruction, the second, a ruptured neurogenic bladder, and the third, megacystic-microcolon-intestinal hypoperistalsis syndrome. When sonographic examination reveals an enlarged fetal bladder, the ureter, kidneys, genitalia, and spine should be evaluated carefully. Although sonography is good at identifying urinary tract abnormalities, it often cannot provide the specific diagnosis or cause. We recommend frequent sonographic monitoring to evaluate such fetuses for persistence of or changes in bladder enlargement and for changes in the volume of amniotic fluid because these signs may be indicators of abnormalities of renal function and risk factors for a poor prognosis. Analysis of fetal electrolyte levels can also aid in determining the prognosis and whether the condition is amenable to therapeutic intervention.
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Affiliation(s)
- Michael G Pinette
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Maine Medical Center, 887 Congress Street, Suite 200, Portland, Maine 04102, USA
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Cvitković-Kuzmić A, Brkljacić B, Ivanković D, Grga A. Ultrasound assessment of detrusor muscle thickness in children with non-neuropathic bladder/sphincter dysfunction. Eur Urol 2002; 41:214-8; discussion 218-9. [PMID: 12074411 DOI: 10.1016/s0302-2838(01)00023-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To measure detrusor muscle thickness in children with non-neuropathic bladder/sphincter dysfunction (NNBSD), and to evaluate the difference between children with various bladder dysfunctions and those with normal urodynamics. MATERIALS AND METHODS In 139 children the urodynamic study was performed, and the detrusor of the anterior bladder wall was measured using high-frequency ultrasonography (US). Children were categorized into five groups, according to urodynamic findings. Differences in detrusor thickness between groups were tested by one-way ANOVA with post hoc Scheffé test. RESULTS Forty-six children (33.1%) had normal urodynamics, and mean (+/-S.D.) detrusor thickness 1.3 +/- 0.5 mm (range 0.5-3.0). Fifty-two (37.4%) had urge syndrome, with detrusor thickness of 2 +/- 0.7 mm (1.0-3.6). Thirty-three (23.7%) had dysfunctional voiding, with detrusor thickness of 2.6 +/- 0.5 mm (1.5-3.6). Four (2.9%) had lazy bladder, with detrusor thickness of 0.9 +/- 0.1 mm (0.8-1.0), and four had anatomical infravesical obstruction, with detrusor thickness of 4.4 +/- 0.3 mm (4-4.6). The mean detrusor thickness in all children with NNBSD was 2.2 +/- 0.7 mm (range 0.8-3.6). Multiple comparisons showed significant difference between all groups, except between children with normal urodynamics and children with lazy bladder. CONCLUSION There is statistically significant difference in mean detrusor thickness between children with normal urodynamics and children with NNBSD. However, due to the overlap of measured values, it is not possible to determine the cut-off value that could be used to distinguish children with and without NNBSD.
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Avni FE, Garel L, Hall M, Rypens F. Perinatal Approach to Anomalies of the Urinary Tract, Adrenals and Genital System. ACTA ACUST UNITED AC 2002. [DOI: 10.1007/978-3-642-56402-4_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Abstract
Ultrasound routinely identifies the fetal bladder from 10 weeks of gestation. Understanding the normal embryology of the fetal bladder forms the basis of understanding the mechanisms for pathology. Early onset megacystis <12 mm (maximum diameter) frequently regresses spontaneously however when associated with other structural abnormalities 40% are chromosomally abnormal. Survival in this group is rare and the underlying histopathology is of urethral fibrostenosis. Second and third trimester megacystic indicates a heterogenous group where a precise antenatal diagnosis may be impossible. A distended thick wall bladder associated with a dilated posterior urethra and oligohydramnios is pathonemonic of posterior urethral valves; without this combination of ultrasound signs the underlying pathology is less certain. Prediction of other aetiologies for the megacystis is less accurate but includes primary reflux, cloacal plate, urethral duplication and megacystic microcolon in the differential diagnosis. Robust published data is currently unavailable to define appropriate management for individual cases of megacystis. Therefore current best practice for antenatal management will be discussed.
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Affiliation(s)
- J McHugo
- Department of Radiology, Birmingham Women's Hospital, Birmingham, UK
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Affiliation(s)
- A A Shokeir
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
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Shokeir AA, Nijman RJ. Antenatal hydronephrosis: changing concepts in diagnosis and subsequent management. BJU Int 2000; 85:987-94. [PMID: 10792193 DOI: 10.1046/j.1464-410x.2000.00645.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- A A Shokeir
- Urology & Nephrology Center, Mansoura University, Mansoura, Egypt
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Peters CA. Lower urinary tract obstruction: clinical and experimental aspects. BRITISH JOURNAL OF UROLOGY 1998; 81 Suppl 2:22-32. [PMID: 9602792 DOI: 10.1046/j.1464-410x.1998.0810s2022.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- C A Peters
- Department of Urology, Children's Hospital, Boston, MA, USA
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Abstract
As many as 1% of newborn infants have a prenatal diagnosis of hydronephrosis or significant renal pelvic dilation. Hydronephrosis often is caused by nonobstructive conditions. The likelihood of significant urologic pathology is directly related to the size of the fetal renal pelvis, and 90% with an anteroposterior diameter more than 2 cm need surgery or long-term urologic medical care. Following delivery, antibiotic prophylaxis should be administered and a renal sonogram and voiding cystourethrogram should be obtained. If there is grade 3 or 4 hydronephrosis, usually a diuretic renogram is recommended also. Pediatric urologic or pediatric nephrologic consultation usually is helpful in planing evaluation and treatment. Prenatal recognition of hydronephrosis allows neonatal diagnosis and treatment of urologic pathology, preventing complications of pyelonephritis and obstruction.
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Affiliation(s)
- J S Elder
- Department of Urology and Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Kaefer M, Peters CA, Retik AB, Benacerraf BB. Increased Renal Echogenicity: A Sonographic Sign for Differentiating Between Obstructive and Nonobstructive Etiologies of in Utero Bladder Distension. J Urol 1997. [DOI: 10.1016/s0022-5347(01)64380-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Martin Kaefer
- From the Division of Urology and Department of Radiology, Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Craig A. Peters
- From the Division of Urology and Department of Radiology, Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alan B. Retik
- From the Division of Urology and Department of Radiology, Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Beryl B. Benacerraf
- From the Division of Urology and Department of Radiology, Children's Hospital and Harvard Medical School, Boston, Massachusetts
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Increased Renal Echogenicity. J Urol 1997. [DOI: 10.1097/00005392-199709000-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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The Sonographic Diagnosis of Infravesical Obstruction in Children: Evaluation of Bladder Wall Thickness Indexed to Bladder Filling. J Urol 1997. [DOI: 10.1016/s0022-5347(01)65127-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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24
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The Sonographic Diagnosis of Infravesical Obstruction in Children. J Urol 1997. [DOI: 10.1097/00005392-199703000-00092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schoor RA, Canning DA, Bella RD, Broderick GA, Snyder HM, Duckett JW, Krasnapolski L, Wein AJ, Levin RM. Ultrasound diagnosis of bladder outlet obstruction in rabbits. Neurourol Urodyn 1994; 13:559-69. [PMID: 7833973 DOI: 10.1002/nau.1930130510] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
One of the primary characteristics of partial outlet obstruction secondary to BPH is an increase in bladder mass commonly referred to as bladder hypertrophy. This condition has been simulated in rabbits by the partial ligation of the catheterized urethra. Ultrasonography has been utilized in both adult and pediatric urology to visualize the bladder and diagnose specific bladder disorders. The aim of the present study is to determine if ultrasonography can visualize bladder wall hypertrophy induced by obstruction. Partial outlet obstructions were created in NZW rabbits using standard methodologies, and then 5 to 7 days later, sonography was performed. The films were read by both the principal investigator and blinded investigators instructed to determine bladder wall thickness and from this predict the bladder weight. Then results were correlated with cystometrograms (CMGs) and whole bladder weights. Both the principal investigator and the blinded investigators were consistently able to distinguish obstructed from control bladders based solely on sonographic depictions of relative bladder wall thickness. In addition, the investigators were able to distinguish between low (control), medium, and high bladder weights based on sonography. The accuracy of predicting the bladder weights increased when cystosonograms were correlated with CMG studies. Thus, the degree of bladder hypertrophy can be accurately estimated by the combination of cmg and ultrasonography.
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Affiliation(s)
- R A Schoor
- Division of Urology, University of Pennsylvania, Phildelphia 19104
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