Paediatric excretory urography at the Port-of-Spain General Hospital, 1985-1987 - abstract

ABSTRACT

In developing countries where ultrasonography and nuclear medicine scanning are not widely available, the intravenous pyelogram (IVP) is the principal method of visualizing the urinary tract. As a result, there exists a real potential for over requesting this relatively expensive study which is unpleasant and not without risk, especially in children. To assess the appropriate use of paediatric IVPs at the Port-of-Spain General Hospital, a retrospective study was done of all IVPs (n=373) performed on children at this institution during the 3-year period, 1985-1987. Radiological abnormalities were reported in 29 percent of cases. The most common abnormal findings were consistent with infection (29 percent) and hydronephrosis (26 percent). The most common indications for radiological study were urinary tract infection (23 percent) and haematuria (17 percent). Problems in making the diagnosis of a urinary tract infection in children were identified as the improper collection and handling of the urine specimen. Based on this survey, almost one-third of children who have IVPs at this institution do not have any indication for doing this potentially dangerous and certainly expensive procedure (AU)