Wang Xinyu,Zhao Yongxiang,Song Hongcheng,et al.Diagnoses and surgical managements of pediatric calyceal diverticulum[J].Journal of Clinical Pediatric Surgery,,22():367-372.[doi:10.3760/cma.j.cn101785-202204004-013]
Diagnoses and surgical managements of pediatric calyceal diverticulum
- Keywords:
- Calyceal Diverticulum; Kidney Diseases; Ultrasonography; Urologic Surgical Procedures; Child
- Abstract:
- Objective To explore the clinical features,diagnosis and treatment of calyceal diverticulum(CD)in children.Methods From January 2010 to October 2021,clinical data were retrospectively reviewed for of 7 CD children.There were 5 boys and 2 girls with a mean age of 47(8-132)months.The average diverticulum size was 6.2(3-9)cm.And the involved side was left(n=3)and right(n=4).The site was upper calyx(n=3)and middle calyx(n=2).The presenting manifestations were renal cystic lesion on prenatal ultrasound(n=3),abdominal pain(n=2),asymptomatic abdominal mass(n=1)and renal cystic lesion with hypertension found incidentally(n=1).The lesion were confirmed by preoperative urinary ultrasound(n=3)and detected intraoperatively(n=4).The surgical procedures included open diverticulectomy(n=2),enlargement of communication after clipping diverticulum(n=3)and tubularized turn-over flap ureteral end-to-side anastomosis(n=2,laparotomy and laparoscopy each).Results During a follow-up period of(3-120)months,the symptoms disappeared and there was no dilated diverticulum or recurrence.One case of ureteropelvic junction obstruction had a marked relief.Renal function remained poor at 20% and was still monitored.Conclusion Pediatric calyceal diverticulum has a low incidence.Recurrent urinary infections,chronic abdominal pain,hematuria and stones due to urinary retention in diverticulum occur approximately in 1/3-1/2 of patients.It is easy to misdiagnose it as a simple renal cyst by ultrasound.However,treatments are totally different and two conditions should be distinguished carefully.Individualized treatments should be adopted depending upon the site and severity of communication,including open diverticulectomy,enlargement of communication after clipping diverticulum and tubularized turn-over flap ureteral end-to-side anastomosis.Prognosis is generally decent.
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Memo
收稿日期:2022-4-2。
通讯作者:宋宏程,Email:songhch1975@126.com