Cases reported "Vesico-Ureteral Reflux"

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1/220. The Ask-Upmark kidney: a form of ascending pyelonephritis?

    The case is presented of a young girl with recurrent urinary tract infection and vesico-ureteric reflux who developed a small scarred kidney and subsequently, hypertension. Pathologically, the renal changes were compatible with those of an Ask-Upmark kidney. The pathogenesis of the Ask-Upmark kidney is discussed. It is postulated that the lesion is not necessarily of congenital origin but may well be related to infection and intrarenal reflux, it is concluded that long-term follow-up of a young patient with a scarred kidney is indicated.
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2/220. Surgical treatment of reflux in completely duplicated ureters.

    Vesicoureteral reflux occurs in approximately 50% of duplex systems that undergo evaluation and most commonly involves the lower renal segment ureter. The therapeutic approach can be tailored for each case after careful evaluation of the anatomic and functional status of each renal unit. If reparative srugery is indicated and only one ureter is involved, then ureteropyelostomy or ureteroureterostomy have yielded excellent results. If more than one ureter is involved with either relfux or obstruction, then reimplantation of the paired ureters is indicated if the renal units are slavageable.
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3/220. Ectopic vas deferens opening into the ureter.

    PURPOSE: A pediatric case of ectopic vas deferens opening into the ipsilateral ureter is reported. methods/RESULTS: Ectopic opening of the vas deferens was detected incidentally at ureterocystotneostomy being performed for vesicoureteral reflux to the solitary kidney of a 7-month-old boy with anorectal anomaly. CONCLUSIONS: The preservation of the patency of the seminal tract is recommended.
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4/220. Vesicoureteral reflux in a boy presenting with difficulty in walking.

    BACKGROUND: We report an uncommon case who presented himself at our hospital with main complaints of high fever and difficulty in walking due to pain on extension of his right lower extremity. methods: He was diagnosed, through investigation of his urinary tract, as having secondary psoas pyomyositis spread from acute pyelonephritis caused by vesicoureteral reflux. RESULTS: He was successfully managed firstly by antibiotic therapy, followed by the correction of reflux by ureteroneovesicostomy.
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5/220. Septic arthritis secondary to vesicoureteral reflux into single ectopic ureter.

    A 3-week-old male infant, born full term without complication, developed septic arthritis of his left shoulder. His joint fluid, blood, and bone marrow were all positive for escherichia coli. urinalysis demonstrated pyuria. urine culture obtained after one dose of ceftriaxone and several doses of nafcillin was negative. work-up revealed a refluxing, right single ectopic ureter with severe hydroureteronephrosis and a non-functioning ipsilateral kidney. After appropriate management of the musculoskeletal infection, he underwent a right nephroureterectomy. Coliform septic arthritis is exceedingly rare in children, with only a few cases reported. We report the first case of septic arthritis with anomalous genitourinary tract development as the source of bacterial seeding. This report re-emphasizes the need to screen the urinary tract in all cases of pediatric gram-negative sepsis.
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6/220. Bladder rupture after inguinal herniotomy.

    An 18-month-old male sustained an extensive bladder injury during a routine right inguinal herniotomy. Primary closure of the remaining detrusor was performed. Three months postoperatively he could void spontaneously, but with a small, contracted bladder and bilateral vesicoureteral reflux. He was stable throughout a 6-month follow-up period. Further surgical options will depend upon the bladder capacity and the grade of reflux.
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7/220. ventricular flutter in a neonate--severe electrolyte imbalance caused by urinary tract infection in the presence of urinary tract malformation.

    male infants under the age of 3 months presenting with pyelonephritis in the presence of urinary tract malformation (UTM) are prone to transient pseudohypoaldosteronism. This may resemble congenital adrenal hyperplasia (CAH). hyponatremia, hyperkalemia, dehydration, and metabolic acidosis are the primary findings that permit the diagnosis of CAH. We report a case of transient pseudohypoaldosteronism resulting from pyelonephritis and vesicouretric reflux. The 17-day-old boy presented with a salt-losing episode simulating adrenal insufficiency. An initial diagnosis of CAH was made. The severe metabolic imbalance resulted in ventricular flutter that resolved after correction of the metabolic acidosis and the electrolyte and volume depletion. early diagnosis is essential because both conditions are potentially fatal and treatment differs significantly. Differential diagnosis may be achieved by urinalysis and abdominal ultrasound scan.
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8/220. Fanconi's anemia with solitary crossed renal ectopia, vesicoureteric reflux, and genital abnormalities.

    Fanconi's anemia is an autosomal recessive disease, the main feature being pancytopenia secondary to bone-marrow hypoplasia. However, multiple congenital abnormalities may be encountered, urogenital malformations being common. We describe a patient with solitary crossed renal ectopia, vesicoureteric reflux, hypospadias, and unilateral undescended testis with absent vas deferens.
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9/220. citrobacter diversus urosepsis and cerebral abscess in a child with antenatal hydronephrosis.

    One percent of all pregnancies are found to have an antenatal abnormality; of these, 20% involve the genitourinary system. Today, controversy still exists regarding the postnatal management of some antenatal abnormalities detected by ultrasound. We present a case in which antenatal hydronephrosis initially detected by ultrasound appeared to resolve in utero. Postnatally, the child developed citrobacter diversus urosepsis, meningitis, and cerebral abscess. Voiding cystourethrogram obtained after resolution of sepsis revealed grade IV reflux. This case underscores the importance of a full postnatal evaluation for all children with antenatal hydronephrosis and alerts clinicians to a virulent pathogen not commonly associated with urinary tract infection.
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10/220. Endoscopic treatment of vesicoureteral reflux in children with glutaraldehyde cross-linked bovine dermal collagen. Short-term results.

    BACKGROUND: Endoscopic treatment using glutaraldehyde cross-linked (GAX) collagen was conducted on 4 children with bilateral primary vesicoureteral reflux (VUR)..... a 1-year-old boy and three 5- to 8-year-old girls $B!D (Ball having a history of repeated hospitalization for fever due to acute pyelonephritis, visiting as pediatric outpatients regularly and receiving antibiotics continuously. By international VUR classification, 4 ureters were grade 3, 2 grade 4, and 2 grade 5. methods: After nonallergy to GAX collagen was confirmed intracutaneously, a needle was used through a 9.5 Fr cystoscope channel to puncture bladder mucosa 4 to 5 mm from the affected ureteral orifice at 6 o'clock under general anesthesia; 1.1 to 1.9 ml of GAX collagen was injected immediately below affected orifices. RESULTS: Three months after surgery, voiding cystourethrography showed reflux had disappeared in 6 ureters, for a short-term success rate of 75%. VUR in the Remaining 2 ureters improved from grade 3 to 1 and from grade 5 to 4. No postoperative urinary tract infection occurred and antibiotics were stopped. CONCLUSION: Since GAX collagen is less viscous than Teflon paste, it is easily injected into submucosa, does not form granuloma or migrate to other organs, and is noncarcinogenic. Endoscopic VUR treatment using GAX collagen is indicated when less invasion and shorter hospitalization are considered, although it requires general anesthesia, which itself involves some risk.
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