ABSTRACT
RESUMEN Introducción: las malformaciones congénitas renales y de las vías urinarias constituyen un grupo heterogéneo de anomalías secundarias a un proceso anormal en el desarrollo embrionario del sistema renal. Objetivo: profundizar en los aspectos relacionados con el diagnóstico precoz de las malformaciones congénitas renales y de vías urinarias, como causa frecuente de la enfermedad renal crónica oculta en la edad pediátrica, desde una perspectiva integral y personalizada, sobre la base de un enfoque médico social. Métodos: se realizó una revisión sistemática sobre el tema en las bases de datos: EBSCO, SciELO, Scopus, PubMed, y en revistas de Nefrología pediátrica, de Pediatría, de Genética y de Teratología. Los artículos fueron publicados en idioma español o inglés. Se realizó un análisis de contenido directo para lograr la actualización teórica del tema con un enfoque médico social. Conclusiones: el desarrollo de la Nefrología pediátrica constituye una línea de trabajo del MINSAP. Sus principios son: la intersectorialidad, la prevención y la participación de especialidades afines (de manera que se alcancen resultados asistenciales, docentes e investigativos que determinen mayor calidad en el diagnóstico precoz de las malformaciones congénitas renales y de vías urinarias). Dicha afección es causa frecuente de la enfermedad renal crónica oculta en la edad pediátrica, desde una perspectiva integral y personalizada, sobre la base de un enfoque médico social.
ABSTRACT Introduction: congenital renal and urinary tract malformations constitute a heterogeneous group of anomalies secondary to an abnormal embryonic development of the renal system. Objective: to study in depth the aspects related to the early diagnosis of congenital renal and urinary tract malformations, as a frequent cause of occult chronic kidney disease in the paediatric age group, from an integral and personalized perspective, based on a medical and social approach. Methods: a systematic review on the subject was carried out in the following databases: EBSCO, SciELO, Scopus, PubMed, and in journals of Paediatric Nephrology, Paediatrics, Genetics and Teratology. The articles were published in Spanish or English languages. A direct content analysis was performed to achieve the theoretical update of the topic with a medical and social approach. Conclusions: the development of Paediatric Nephrology constitutes a line of work of MINSAP. Its principles are intersectoriality, prevention and participation of related specialities (in order to achieve care, teaching and research results that determine greater quality in the early diagnosis of congenital renal and urinary tract malformations). This condition is a frequent cause of occult chronic kidney disease in the paediatric age group, from an integral and personalized perspective, based on a medical and social approach.
Subject(s)
Prenatal Diagnosis , Congenital Abnormalities , Urinary Tract/abnormalities , Health-Disease Process , Renal Insufficiency, Chronic/etiologyABSTRACT
Background: CT has evolved from single–detector row scanners into multi–detector row helical volumetric acquisition techniques, and these advances have had a significant impact on imaging of the urinary tract. Aim and objectives: To evaluate the CTU compare to other imaging modalities for urinary tract abnormalities in light of present knowledge, To study the role of CTU in evaluation of various abnormalities those are not detected by conventional IVP, Benefits of CTU over IVP, To provide information about the extent of the lesions involving kidneys and its relation to surrounding structure and Characterizing the lesions whether they are benign or malignant and helping the surgeons for the further management, Grading the renal injuries. Materials and methods: Data was collected from patients who attended the surgical O.P.D. or emergency of S.S.G.H., Baroda with clinically suspected renal abnormalities. A study was conducted over a period of two years on 50 patients with clinically suspected renal abnormalities. Informed consent was taken from every patient. Patients were evaluated with Multidetector Computed Tomography (G.E. Bright Speed). Results: Our Study included 10 patients of renal stones, 8 patients of renal masses, 3 patients of pyelonephritis, 7 patients of renal injury, 5 patients of PUJ obstruction, 7 patients of ureteric stricture, 5 patients of anomalies, and 5 patients of bladder mass. Among all pathology CT urography is more helpful and gives better imaging findings as compare to conventional urography that helps in better management of patients. Conclusion: CTU gives reliable information not about the extent of lesion but also the characteristics of lesions which makes surgeons to take proper decision aboutthe further management of patients, it also avoids unnecessary laparotomy surgery in case of blunt abdominal trauma patients by giving the precious extent of renal injuries. For all these gold standard benefits of MDCTU over conventiona Rathva AM, Singla H. MDCT urography as a one stop shop for urinary tract abnormalities at present era. IAIM, 2016; 3(3): 52-64. Page 53 IVP makes MDCTU as “one stop shop” for urinary tract abnormalities and nearly completely replacing the IVP in recent era.
ABSTRACT
Objective: To demonstrate didactically the different ultrasound findings of various congenital malformations of the genitourinary system. Methods: Twelve cases were retrospectively studied, comprising patients who presented with genitourinary tract malformations (with or without related symptoms), detected by ultrasound testing carried out with Phillips ATL / HDI - 5000 ultrasound equipment, during the period of August 2007 to June 2009 at the Imaging Department of the Hospital Israelita Albert Einstein. Results: Six patients were females and six were males, and ages varied from a few hours of life to 15 years and 9 months. All individuals were evaluated and accompanied by the Pediatric Radiology sector of the Hospital Israelita Albert Einstein. The study was carried out as follows: two cases of hydrocolpos, one of them a result of imperforate hymen and one a case a congenital stenosis of the ureteropyelic junction, one case of ureterocele, one case of bilateral double collection system, one case of horseshoe kidney, one case of Hutchs diverticulum, two cases of pelvic kidney, one of them with hydronephrosis, one case of multicystic dysplastic kidney, one case of polycystic kidney (adult form), and one case of congenital megaureter. Conclusions: The ultrasonographic study is a valuable method for the early identification, often in the uterus, of these and several other treatable anomalies of the genitourinary tract. Additionally, it also presents the advantage of not using ionizing radiation, which is very significant, especially in the pediatric age group.
Objetivo: Demonstrar de maneira didática os diferentes achados ultrassonográficos de diversas malformações congênitas do sistema geniturinário. Métodos: Foram estudados retrospectivamente 12 casos de pacientes que apresentavam malformações do trato geniturinário (com ou sem sintomas relacionados), detectados nos exames de ultrassonografia com aparelhos de ultrassom Phillips ATL / HDI - 5000, no período de agosto de 2007 a junho de 2009 no Departamento de Imagem do Hospital Israelita Albert Einstein. Resultados: Seis pacientes eram do sexo feminino e seis do sexo masculino, e as idades variaram entre algumas horas de vida até 15 anos e 9 meses. Todos foram avaliados e acompanhados pelo setor da radiologia pediátrica do Hospital Israelita Albert Einstein. Os casos estudados foram: dois casos de hidrocolpo um deles consequente a hímen imperfurado, um caso de estenose congênita da junção ureteropiélica, um caso de ureterocele, um caso de duplicidade do sistema coletor bilateral, um caso de rim em ferradura, um caso de divertículo de Hutch, dois casos de rim pélvico, um deles apresentando hidronefrose, um caso de rim displásico multicístico, um caso de rim policístico (forma adulta) e um caso de megaureter congênito. Conclusões: O estudo ultrassonográfico é um valioso método para a identificação precoce, muitas vezes intrauterina, dessas e de diversas outras anomalias do trato geniturinário passíveis de tratamento. Além disso, apresenta também a vantagem de não utilizar radiação ionizante, o que é de grande importância especialmente na faixa etária pediátrica.