A Short Term study on Pelviureteric Junction Obstruction in Children.

Ravikumar, A (2006) A Short Term study on Pelviureteric Junction Obstruction in Children. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION : Hydronephrosis is defined as dilatation of the renal collecting system as a result of either inadequate drainage or retrograde flow of urine. Pelviureteric junction obstruction (PUJ stenosis) represents 44% of all postnatal causes of hydronephrosis. Congenital hydronephrosis, caused by pelviureteric junction obstruction, has challenged the ingenuity of paediatric surgeons and remains one of the most enigmatic clinical problems today. Historically, pain, infection, stone and hematuria have been the classic and compelling indications for intervention. Currently with the increased widespread use of high-resolution real time fetal ultrasonography, antenatal hydronephrosis with minor dilatation of the upper urinary tract is being detected with increased frequency. The challenge for today’s Paediatric surgeons in the management of hydronephrosis is to decide which patients can be observed, which can be medically managed and which require surgery. AIM OF THE STUDY : 1. To analyse the incidence of pelviureteric junction obstruction. 2. To analyse the clinical presentation. 3. To analyse the various modalities of treatment. 4. To analyse the pre and postoperative function of the affected kidney. MATERIALS AND METHODS : 60 cases of hydronephrosis were studied in the department of Paediatric surgery in Madurai medical college, Madurai during the period from July 2003 to September 2005. Out of 60, 41 had Pelviureteric junction obstruction. All cases were evaluated by recording antenatal history, age, sex, presenting symptoms, signs and if there is any previous treatment. All the cases were investigated with urine culture, blood urea, creatinine estimation, ultrasonogram abdomen and intravenous urogram. Some were subjected to CT scan abdomen with contrast and Diuretic renogram. The conventional open Anderson Hynes pyeloplasty was done in 39 cases. All the patients were followed regularly with ultrasonogram and few of them with intravenous pyelogram and diuretic renogram. CONCLUSION : The incidence and presentation in this study are consistent with the most of the reports given in the literatures. Eventhough the other series show the incidence of antenatally diagnosed hydronephrosis is more, in this series ironically only 3 cases had antenatally diagnosed hydronephrosis. The results of the dismembered pyeloplasty (Anderson Hynes pyeloplasty) are comparable with any other reports in the literature. In conclusion the Anderson Hynes pyeloplasty is the most preferred method to treat pelviureteric junction obstruction.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Pelviureteric Junction Obstruction ; Children ; Short Term study.
Subjects: MEDICAL > Paediatric Surgery
Depositing User: Kambaraman B
Date Deposited: 28 Jul 2017 03:31
Last Modified: 28 Jul 2017 03:42
URI: http://repository-tnmgrmu.ac.in/id/eprint/2298

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