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Ureteropelvic junction obstruction
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Lauren E. Corona, Kate H. Kraft
Patients who present with both vesicoureteric reflux and ipsilateral UPJ obstruction can be complicated. High-grade vesicoureteric reflux can distort the appearance of the UPJ. One should ask if the dilation of the renal pelvis is due to the reflux, or whether it is a separate concern. In these cases, the surgeon should first determine if there is truly an obstruction. Diuretic renal scintigraphy will rule out most cases of pseudo-UPJ obstruction. When obstruction has been established, the UPJ obstruction should be repaired first, and the reflux addressed later. Repairing the reflux first risks making the obstruction worse and jeopardizes the kidney.
The patient with acute renal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
There are three specific areas in the kidney. There is an outer section called the renal cortex, which contains all of the glomeruli and portions of the tubule. The inner section is known as the renal medulla, and this contains the straight segments of the proximal and distal tubules and the collecting ducts. Renal pyramids are found here, and these cone-shaped areas have their apices ending in the papillae, which open into the minor calyx. Urine passes from the collecting ducts in the pyramid to two small cavities, the minor calyces and the major calyces, and, from here, it enters the renal pelvis. Finally, the renal pelvis is formed from the expanded upper section of the ureter and it acts as a collecting space.
Acid-Base, Electrolyte And Renal Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Arrange an urgent renal tract ultrasound to look at the size of the kidneys, particularly looking for evidence of obstruction anywhere from the renal pelvis to the bladder outlet. Shrunken kidneys suggest an acute on chronic process.Exceptions are polycystic kidneys, amyloid or HIV nephropathy, and diabetic nephropathy, which are associated with enlarged or preserved renal size even with chronic renal failure.
Prenatal Detection of Vesico-Allantoic Cyst: Ultrasound and Autopsy Findings
Published in Fetal and Pediatric Pathology, 2023
Maria Paola Bonasoni, Giuseppina Comitini, Ottavia Cavicchioni, Veronica Barbieri, Giulia Dalla Dea, Andrea Palicelli, Lorenzo Aguzzoli
A 29-year-old woman, gravida 3, para 2, was referred to our institution at 13 WGA for a cystic lesion found by US in the umbilical cord. The mother was on 100 g thyroxin after being treated for hyperthyroidism wtih radioactive iodine therapy. The US repeated at 17 WGA showed a round hypoechoeic cyst within the umbilical cord measuring 40 × 30 mm, communicating with the fetal bladder. The umbilical cord vessels surrounded the cyst with no evidence of flow impairment by Doppler US. Biometry was consistent with dates and no other anomalies were detected. Follow-up scan at 19 weeks’+2 days confirmed the presence of a vesico-allontoic cyst of the same dimensions of the previous exam. There was bilateral dilatation of the renal pelvis (5-6 mm) and the ureters. Hypospadias was also identified (Figure 1). Amniotic fluid was within normal range. Umbilical cord flow was regular (Figure 2).
Twelve tips for interpreting abdominal CT scans
Published in Medical Teacher, 2021
Sailantra Sivathasan, Jakub Nagrodzki, David McGowan
Initially, identify the kidneys and note any asymmetry in size or location and any anatomical variations. Look for the bladder and any signs of obvious pathology such as cysts, tumours or gross dilatation. Then identify the collecting system of one of the kidneys and follow the ureter closely from the renal pelvis to the bladder. Repeat this for the opposite side. Look for any obvious dilatation and/or asymmetry in size or location of the kidneys and ureters, potentially indicating polycystic kidneys, a tumour or obstructive uropathy. Also look for signs of calculi, such as bright white signal in the lumen of the renal pelvis, ureter or bladder. If stone disease is suspected clinically and there is contrast present within the lumen of the ureter it can make the test difficult to interpret, unless there are signs of absolute blockage with no contrast after a certain point.
A Case of a Derivative Chromosome: der(Y)t(Y;18)Pat with Congenital Abnormalities
Published in Fetal and Pediatric Pathology, 2021
Shufang Huang, Yu Xia, Hong Ding, Yonghua Wang, Yueheng Wu, Shaoxian Chen, Jian Zhuang, Ping Li
The male proband was born at 36 weeks gestation weighing 2.3 kg via cesarean delivery due to fetal distress. Due to the onset of respiratory distress, when he was 13 days old he was admitted to the neonatal intensive care unit (NICU) for 15 days until his subsequent demise. The proband’s parents were both healthy and phenotypically normal. Blood chromosome analysis was obtained when 14 days old. Syndromic features noted at birth included facial abnormalities such as microcephaly, a broad forehead, small eyes, low-set ears and a clenched fist with overlapping fingers (Fig. 1). Echocardiography and computed tomography showed congenital heart disease i.e. an atrial septal defect (ASD) and a ventricular septal defect (VSD). Renal ultrasonic and magnetic resonance imaging (MRI) showed the renal pelvis and ureter to be bilaterally markedly dilated. Video bronchoscopy showed a hypopharyngeal stricture. The neonate underwent ASD and VSD repair. Because of persistent refractory heart failure, the child died at 28 days of life. The couple refused autopsy.