Is this Kidney obstructed

• 19 Mar 2021 09:13:24 PM
• |Pediatic Urology

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Comments(3)

• 

  Dr. Anil Takvani

  19 Mar 2021 10:53:09 PM

  Left ectopic kidney is obstructed. 

  Recurrent pain

  Lumpish palpation

  Increased CTT 

  Retention of redioisotope in kidney in delayed, erect posture plates 

  Last is drainage curve. 

  As it is ectopic/pelvic kidney I would wish to do VCUG but as ureter is not dilated and as there is no history of UTI, we can avoid it.

  
  

  Child needs pyeloplasty as an elective procedure. 

  
  

  By the way ectopic /pelvic position justified CECT else we would have avoided it. 

  
  

  Thanks 

• 

  Gyanendra Sharma

  20 Mar 2021 10:16:39 AM

  I would agree with Anil

  Lump appearing & disappearing is S/O Dietl's crisis

  CTT is delayed

  I usually also ask for NORA which in my view is a better indicator of pelvic emptying then T 1/2 as it takes gravity into consideration

  Post micturition & erect images show retention of tracer which is a good indicator of delayed emptying of the pelvic

  This kidney looks obstructed and I would intervene in this patient

• 

  Lalit Shah

  20 Mar 2021 11:44:41 AM

  Yes obstructed

  Surgery stat or reassessment after 6 months,would both be my option for the present. Informed shared decision after detail counselling would be decider.