Ureteropelvic junction obstruction: three clinical cases with first symptoms during adolescence
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v28.i1.13536Keywords:
adolescence, hydronephrosis, ureteral obstructionAbstract
Ureteropelvic junction obstruction (UPJO) is defined as urine flow blockage occurring where the ureter enters the kidney and is presented as urinary tract dilatation (UTD), formerly named hydronephrosis. The condition may be congenital or acquired. Most UTD are diagnosed by antenatal ultrasonography, but some cases present later. In adolescence, clinical manifestations include intermittent flank or abdominal pain, hematuria, nephrolithiasis, urinary tract infection, deterioration of renal function, or arterial hypertension. The imaging modality of choice to diagnose UTD is ultrasonography (US). A diuretic renography will allow to identify UPJO. Treatment goals are to prevent renal function deterioration and relieve symptoms. Although conservative treatment measures are favored, some patients require surgical correction (pyeloplasty). Three clinical cases with first symptom onset during adolescence are presented. The first case is a 14-year-old boy with abdominal pain suspected to correspond to acute appendicitis; the second case is a healthy 15-year-old female which presented with dysuria and lumbar pain; the third case is a 15-year-old female with prenatal diagnosis of left ureteropelvic dilation but no further medical problems, with left lumbar pain, dysuria, and fever.
Conclusion: A high degree of suspicion is required to include UPJO in the differential diagnosis of flank or back pain in adolescents.
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References
Hashim H, Woodhouse CRJ. Ureteropelvic Junction Obstruction. Eur Urol Suppl 2012; 11:25-32. DOI: 10.1016/j.eursup.2012.01.004
Baskin LS. UpToDate. Congenital ureteropelvic junction obstruction. Available at: https://www.uptodate.com/contents/congenital-ureteropelvic-junction-obstruction?source=search_result&search=Congenital+ureteropelvic+junction+obstruction&selectedTitle=1%7E27. Accessed September 9, 2016.
Chen F. Genetic and developmental basis for urinary tract obstruction. Pediatr Nephrol 2009;24:1621-1632. DOI:10.1007/s00467-008-1072-y.
Poudel A, Afshan S, Dixit M. Congenital Anomalies of the Kidney and Urinary Tract. NeoReviews 2016;17:e18-e27. DOI: 10.1542/neo.17-1-e18
Alberti C. Congenital ureteropelvic junction obstruction: physiopathology, decoupling of tout court pelvic dilatation-obstruction semantic connection, biomarkers to predict renal
damage evolution. Eur Rev Med Pharmacol Sci 2012; 16: 213-219.
Lee H, Han SW. Ureteropelvic Junction Obstruction: What We Know and What We Don’t Know. Korean J Urol 2009;50:423-431. DOI:10.4111/kju.2009.50.5.423
Rosenblum,ND. UpToDate. Evaluation of congenital anomalies of the kidney and urinary tract (CAKUT). Available at: https://www.uptodate.com/contents/evaluation-of-congenital-anomalies-of-the-kidney-and-urinary-tract-cakut?source=search_result&search=Evaluation+of+congenital+anomalies+of+the+kidney+and+urinary+tract+%28CAKUT%29.&selectedTitle=2%7E98. Accessed September 9, 2016.
Trnka P, Hiatt MJ, Tarantal AF, et al. Congenital urinary tract obstruction: defining markers of developmental kidney injury. Pediatr Res 2012;72(5):446-454. DOI:10.1038/pr.2012.113
Piscitelli A, Galiano R, Serrao F, et al. Which cystography in the diagnosis and grading of vesicoureteral reflux? Pediatr Nephrol 2008; 23:107–110. DOI 10.1007/s00467-007-0651-7
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