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Morphological observations on changes of renal vascular architecture in severe hydronephrosis in children
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INTERNATIONAL ABSTRACTS OF PEDIATRIC SURGERY
Sixteen pediatric patients experienced 18 episodes of transient postoperative hypertension after urological operations. The hypertension usually began 1 to 9 days postoperatively and lasted an average of 3.8 days. No therapy was necessary. Control patients undergoing nonurological operations developed similar but transient postoperative hypertension of much shorter duration. Relative renal ischemia due to (1) surgical stress with sympathetic tone elevation and renal arterial vasoconstriction, (2) ureter renal reflexes resulting in renal vascular constriction, and (3) generalized increased lability of vascular bed in such children, are suggested causes of the phenomenon.--William K. Sieber. NONTRAUMATIC HEMATURIA
IN CHILDREN.
W. E. Harrison, H. N. Habib, E. I. Smith, and R. P. McCarthy. J. Urol. 96:95-100, July, 1966. During a 6 year period 80 children were admitted to Children's Mercy Hospital, Kansas City, Missouri, with hematuria where trauma was not implicated. There was no significant sex difference. Glomerulonephritis was the cause of hematuria in 31 children. Sixteen had hemorrhagic cystitis. In 12 cases no etiology was found. Four had urethritis. Three had pyelonephritis. Fourteen had a variety of causes including ureteral stricture, Henoch-Schoenlein purpura, hemophilia, hepatic insufficiency, thrombocytopenic purpura, ureteropelvic junction obstruction with pyelonephritis, acute cystitis from vesical neck contracture, urethral prolapse, Wilms' tumor, bilateral hydronephrosis with pyelonephritis, trigonal ulcer, hemoglobinuria, subacute' bacterial endocarditis, and horseshoe kidney with partial obstruction. The authors believe that any child with hematuria deserves a complete workup; tumor is rarely the cause for hematuria in childhood.--W. Hardy Hendten.
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MORPHOLOGICAL OBSERVATIONS ON CHANGES OF RENAL VASCULAR ARCHITECTURE IN SEVERE HYDRONEPHROSIS IN CHILDREN. R. Domini. Riv Chir. Pediat. 8:49-54, Jan-March, 1966. Renal vascular architecture was studied by means of plastic casts of 12 kidneys
affected by congenital hydronephrosis of patients aged i to 12 years. While in the initial phase of the disease the distortion involves the orientation of the interlobar and interlobular vessels, in the later stages it involves the finer structures through glomerular atrophy and the appearance of an aglomerular network.--C. A. Montagnani. CONGENITAL STENOSIS OF THE PYELOURETERAL JUNCTION. A. Pampaloni. Riv. Clin.
Pediat. 8:71-94, Jan-March, 1966. The discussion is based upon the clinical findings and the surgical treatment of 22 cases. Sex: 13 males, 9 females. Age: major incidence between 2 and 4 years. Side involved: right 8, left 7, bilateral 7, with a total of 29 lesions. Of these 13 were intrinsic, 11 extrinsic and 5 both extrinsic and intrinsic. Symptoms and complications were: infection (50 per cent), fever (40 per cent), vomiting (30 per cent), colicy pain (27 per cent), dull pain (13 per cent), palpable mass (18 per cent), hematuria (18 per cent), albuminuria (18 per cent). Frequency in micturition, dysuria, gastroenteritis, abdominal distension, hyperazotemia, renal rickets and dwarfism were occasionally observed. Renal stones were present in 3 patients. Average onset of synaptoms was 18 months before surgery. Associated urinary malformations were present in 4 cases (18 per cent), double pelvis and ureter in 1 case, renal aplasia or hypoplasia in 2 cases, persistence of fetal lobation of the kidney in 1 case. The preoperative diagnosis was made in all cases on the basis of the clinical and radiological findings (I.V.P. and only occasionally retrograde pyelogram). Surgical treatment was strictly conservative and consisted in Y-V plastic in 4 cases and ureteral resection and anastomosis in 11 cases because of intrinsic obstruction. Section of anomalous polar vessels and section of congenital fibrous bands followed by nephropexy was performed because of extrinsic obstruction. In 2 of these cases a recurrence of the obstruction developed and resection and anastomosis was performed with complete recovery. Severe pyelonephritis developed in one case and nephrectomy was performed later on. No mortality is reported. Results were good in all cases with
INTERNATIONAL ABSTRACTS OF PEDIATRIC SURGERY
Sixteen pediatric patients experienced 18 episodes of transient postoperative hypertension after urological operations. The hypertension usually began 1 to 9 days postoperatively and lasted an average of 3.8 days. No therapy was necessary. Control patients undergoing nonurological operations developed similar but transient postoperative hypertension of much shorter duration. Relative renal ischemia due to (1) surgical stress with sympathetic tone elevation and renal arterial vasoconstriction, (2) ureter renal reflexes resulting in renal vascular constriction, and (3) generalized increased lability of vascular bed in such children, are suggested causes of the phenomenon.--William K. Sieber. NONTRAUMATIC HEMATURIA
IN CHILDREN.
W. E. Harrison, H. N. Habib, E. I. Smith, and R. P. McCarthy. J. Urol. 96:95-100, July, 1966. During a 6 year period 80 children were admitted to Children's Mercy Hospital, Kansas City, Missouri, with hematuria where trauma was not implicated. There was no significant sex difference. Glomerulonephritis was the cause of hematuria in 31 children. Sixteen had hemorrhagic cystitis. In 12 cases no etiology was found. Four had urethritis. Three had pyelonephritis. Fourteen had a variety of causes including ureteral stricture, Henoch-Schoenlein purpura, hemophilia, hepatic insufficiency, thrombocytopenic purpura, ureteropelvic junction obstruction with pyelonephritis, acute cystitis from vesical neck contracture, urethral prolapse, Wilms' tumor, bilateral hydronephrosis with pyelonephritis, trigonal ulcer, hemoglobinuria, subacute' bacterial endocarditis, and horseshoe kidney with partial obstruction. The authors believe that any child with hematuria deserves a complete workup; tumor is rarely the cause for hematuria in childhood.--W. Hardy Hendten.
.....
MORPHOLOGICAL OBSERVATIONS ON CHANGES OF RENAL VASCULAR ARCHITECTURE IN SEVERE HYDRONEPHROSIS IN CHILDREN. R. Domini. Riv Chir. Pediat. 8:49-54, Jan-March, 1966. Renal vascular architecture was studied by means of plastic casts of 12 kidneys
affected by congenital hydronephrosis of patients aged i to 12 years. While in the initial phase of the disease the distortion involves the orientation of the interlobar and interlobular vessels, in the later stages it involves the finer structures through glomerular atrophy and the appearance of an aglomerular network.--C. A. Montagnani. CONGENITAL STENOSIS OF THE PYELOURETERAL JUNCTION. A. Pampaloni. Riv. Clin.
Pediat. 8:71-94, Jan-March, 1966. The discussion is based upon the clinical findings and the surgical treatment of 22 cases. Sex: 13 males, 9 females. Age: major incidence between 2 and 4 years. Side involved: right 8, left 7, bilateral 7, with a total of 29 lesions. Of these 13 were intrinsic, 11 extrinsic and 5 both extrinsic and intrinsic. Symptoms and complications were: infection (50 per cent), fever (40 per cent), vomiting (30 per cent), colicy pain (27 per cent), dull pain (13 per cent), palpable mass (18 per cent), hematuria (18 per cent), albuminuria (18 per cent). Frequency in micturition, dysuria, gastroenteritis, abdominal distension, hyperazotemia, renal rickets and dwarfism were occasionally observed. Renal stones were present in 3 patients. Average onset of synaptoms was 18 months before surgery. Associated urinary malformations were present in 4 cases (18 per cent), double pelvis and ureter in 1 case, renal aplasia or hypoplasia in 2 cases, persistence of fetal lobation of the kidney in 1 case. The preoperative diagnosis was made in all cases on the basis of the clinical and radiological findings (I.V.P. and only occasionally retrograde pyelogram). Surgical treatment was strictly conservative and consisted in Y-V plastic in 4 cases and ureteral resection and anastomosis in 11 cases because of intrinsic obstruction. Section of anomalous polar vessels and section of congenital fibrous bands followed by nephropexy was performed because of extrinsic obstruction. In 2 of these cases a recurrence of the obstruction developed and resection and anastomosis was performed with complete recovery. Severe pyelonephritis developed in one case and nephrectomy was performed later on. No mortality is reported. Results were good in all cases with