ABSTRACT
Congenital pelvi-ureteric junction (PUJ) was found in 29 of 36 renal units explored for impaired pelvic drainage in 34 adults. There was a primary nephrectomy rate of 8.4%, and follow up was poor. The widespread use of ultrasound scan has led to an increase in the number of children with equivocal PUJ obstruction. Where surveillance is inadequate, as is the case in developing countries, we suggest that early operation might lead to better renal salvage in such cases.
Subject(s)
Ureteral Obstruction/congenital , Ureteral Obstruction/therapy , Adolescent , Adult , Aftercare , Developing Countries , Female , Humans , Male , Middle Aged , Nephrectomy , Retrospective Studies , Saudi Arabia , Time Factors , Ultrasonography , Ureteral Obstruction/diagnostic imagingABSTRACT
Fifteen children (11 boys and 4 girls) with severe injuries of the urinary tract were admitted to the Riyadh Central Hospital between 1990 and 1992. Their ages ranged from 2.5 to 12 years (mean 7.3 years), and their injuries were parts of multiple-organ trauma. Following resuscitation, every child was evaluated and staged by either intravenous urography, CT scan or ultrasonography or a combination of these. Commonly associated injuries were to the skeleton, spleen and liver. Two patients with ureteropelvic junction injuries and two girls with traumatic urethropaginal fistulas were not diagnosed. The delay in diagnosis contributed to an increase in morbidity. Despite modern radiological imaging, some severe injuries of the urinary tract can still be missed. Heightened awareness and thorough clinical examination are mandatory for early diagnosis of such injuries in children with multiple injuries.
