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Urinary tract calculi in children
ABSTRACTS
577
drainage. The a u t h o r s conclude that biliary tract exploration for suspected biliary atresia should be done before the infant is 4 m o of age and that Roux-en-Y choledochojejunostomy is the preferred primary surgical procedure when a correctable extrahepatic atresia is discovered. William K. Sieber Familial Bile Duct Malformations Associated With Tubular Renal Insufficiency. A. R. LutzRichner and R. F. Landolt. Helv. Paediatr. Acta 28: 1-12 {March), 1973. Two male siblings, the second and the third children of a c o n s a n g u i n o u s marriage, suffering from severe extrahepatic and intrahepatic biliary hypoplasia were observed from birth to death. Both were found to present also with tubular renal failure with generalized unspecific hyperaminoaciduria, proteinuria, glucosuria, and chronic metabolic acidosis. Further findings consisted in feet malformations and degenerative stigmata. Both brothers failed to thrive in spite of all attempts at appropriate feeding, showed a marked disposition to infections, and died at the age of 4 and 3~ mo, respectively, from interstitial pneumonia. Reports of similar cases were not lbund in the pertinent literature. The a u t h o r s point to congenital m a l f o r m a t i o n associated with inborn error of metabolism as an etiologic hypothesis. C. Bretscher-Dutoit GENITOURINARY
TRACT
The Outlook for Adolescents with Chronic Renal Failure. Carl M. Grusfikin, Barbara M. Korsch, and Richard N. Fine. Pediatr. Clin. North Am. 20:953963 (November), 1973. The technical problems of dialysis and transplantations are the same in adolescents as in adults. The emotional difficulties, however, are greater in adolescents. The ideal transplant donor for any patient is an HLA-identical sibling. In such cases, patient and kidney survival approach 100~o. The next best donor is a parent. Two-year survival in a parent-child transplant is 70~,, to 75~o compared to 45~o. to 50~o for cadaver donors. EdwardJ. Berman Urinary Tract Calculi In Children. A. H. Bennett and A. H. Colodny, J. Urol. 109:318-320 (February), 1973. This report concerns 100 urinary tract storms in 76 patients ranging from 7 to 20 yr of age.
The series included 55 children with unilateral stones without recurrence, 13 with bilateral stones, and eight with unilateral recurrent stones. Twenty stones were related to congeni.tal abnormalities, the m o s t c o m m o n being ureteropelvic junction obstruction. Sixteen were found after ureterosigmoidostomy and were associated with increasing obstruction and infection. These stones were mostly m a g n e s i u m a m m o nium sulfate. Twelve patients had stones resulting from orthopedic immobilization. These stones were c o m p o s e d of calcium oxalate. The metabolic g r o u p included five patients with cystinuria, six patients with uric acid stones, including two children with fatal acute leukemia, and two patients with regional enteritis. There were 15 patients in the idiopathic group in w h o m no chemical or metabolic abnormalities could be found. Initial complaint was pain in 29 patients, infection in 21, and h e m a t u r i a in ten. Sixteen were asymptomatic. Fifty-seven surgical procedures were carried out, the most c o m m o n being nephrolithotomy and pyelolit h o t o m y . - - S . Kim Ureterocele in Childhood. R. Morger. Z. K. Chir. 13:234-240, 1973. O f 896 patients with malformation of the urinary tract seen in 1966 1970, there were five patients with ureterocele. The a u t h o r recomm e n d s with others, that the abnormality should be removed in one operative session. The operation should be started at the kidney to decide whether a h e m i n e p h r e c t o m y or a nephrectomy is necessary. S. Hoffmann Evaluation of Eighty Cases of Ileal Conduits In Children: Indications, Complications and Results. G. E. Del Gado and E. C. Muecke. J.,Urol. 109:311-314 (February), 1973 Eighty patients underwent ileal conduit diversion over a 12-yr period. There were 40 with neurogenic bladders, 22 with obstructive anomalies of the urinary tract, 11 with bladder extrophies, 5 with radical cystectomies, and 2 with bladder contractures. There were f o u r deaths, one directly related to the surgery and three from cancer. The most frequent early complications included w o u n d infection, intestinal obstruction, and dermatitis. Late c o m plications include stomal stenosis (19), dermatitis (13), pyelonephritis (12), stomal bleeders (9), pyocystis (9), intestinal obstruction (7), and calculus formation (5). Other complications in-
577
drainage. The a u t h o r s conclude that biliary tract exploration for suspected biliary atresia should be done before the infant is 4 m o of age and that Roux-en-Y choledochojejunostomy is the preferred primary surgical procedure when a correctable extrahepatic atresia is discovered. William K. Sieber Familial Bile Duct Malformations Associated With Tubular Renal Insufficiency. A. R. LutzRichner and R. F. Landolt. Helv. Paediatr. Acta 28: 1-12 {March), 1973. Two male siblings, the second and the third children of a c o n s a n g u i n o u s marriage, suffering from severe extrahepatic and intrahepatic biliary hypoplasia were observed from birth to death. Both were found to present also with tubular renal failure with generalized unspecific hyperaminoaciduria, proteinuria, glucosuria, and chronic metabolic acidosis. Further findings consisted in feet malformations and degenerative stigmata. Both brothers failed to thrive in spite of all attempts at appropriate feeding, showed a marked disposition to infections, and died at the age of 4 and 3~ mo, respectively, from interstitial pneumonia. Reports of similar cases were not lbund in the pertinent literature. The a u t h o r s point to congenital m a l f o r m a t i o n associated with inborn error of metabolism as an etiologic hypothesis. C. Bretscher-Dutoit GENITOURINARY
TRACT
The Outlook for Adolescents with Chronic Renal Failure. Carl M. Grusfikin, Barbara M. Korsch, and Richard N. Fine. Pediatr. Clin. North Am. 20:953963 (November), 1973. The technical problems of dialysis and transplantations are the same in adolescents as in adults. The emotional difficulties, however, are greater in adolescents. The ideal transplant donor for any patient is an HLA-identical sibling. In such cases, patient and kidney survival approach 100~o. The next best donor is a parent. Two-year survival in a parent-child transplant is 70~,, to 75~o compared to 45~o. to 50~o for cadaver donors. EdwardJ. Berman Urinary Tract Calculi In Children. A. H. Bennett and A. H. Colodny, J. Urol. 109:318-320 (February), 1973. This report concerns 100 urinary tract storms in 76 patients ranging from 7 to 20 yr of age.
The series included 55 children with unilateral stones without recurrence, 13 with bilateral stones, and eight with unilateral recurrent stones. Twenty stones were related to congeni.tal abnormalities, the m o s t c o m m o n being ureteropelvic junction obstruction. Sixteen were found after ureterosigmoidostomy and were associated with increasing obstruction and infection. These stones were mostly m a g n e s i u m a m m o nium sulfate. Twelve patients had stones resulting from orthopedic immobilization. These stones were c o m p o s e d of calcium oxalate. The metabolic g r o u p included five patients with cystinuria, six patients with uric acid stones, including two children with fatal acute leukemia, and two patients with regional enteritis. There were 15 patients in the idiopathic group in w h o m no chemical or metabolic abnormalities could be found. Initial complaint was pain in 29 patients, infection in 21, and h e m a t u r i a in ten. Sixteen were asymptomatic. Fifty-seven surgical procedures were carried out, the most c o m m o n being nephrolithotomy and pyelolit h o t o m y . - - S . Kim Ureterocele in Childhood. R. Morger. Z. K. Chir. 13:234-240, 1973. O f 896 patients with malformation of the urinary tract seen in 1966 1970, there were five patients with ureterocele. The a u t h o r recomm e n d s with others, that the abnormality should be removed in one operative session. The operation should be started at the kidney to decide whether a h e m i n e p h r e c t o m y or a nephrectomy is necessary. S. Hoffmann Evaluation of Eighty Cases of Ileal Conduits In Children: Indications, Complications and Results. G. E. Del Gado and E. C. Muecke. J.,Urol. 109:311-314 (February), 1973 Eighty patients underwent ileal conduit diversion over a 12-yr period. There were 40 with neurogenic bladders, 22 with obstructive anomalies of the urinary tract, 11 with bladder extrophies, 5 with radical cystectomies, and 2 with bladder contractures. There were f o u r deaths, one directly related to the surgery and three from cancer. The most frequent early complications included w o u n d infection, intestinal obstruction, and dermatitis. Late c o m plications include stomal stenosis (19), dermatitis (13), pyelonephritis (12), stomal bleeders (9), pyocystis (9), intestinal obstruction (7), and calculus formation (5). Other complications in-