Misdiagnosis Analysis of 9 Children with Congenital Kidney and Ureter Malformation Combined with Hydronephrosis

LI Gang-long; MA Hong; YANG Yuan-gui; LIU Hong; LIU Bin; SHANG Xian-hui; WANG Cao; LU Qiang

doi:10.3969/j.issn.1002-3429.2017.01.015

Abstract：Objective To investigate clinical characteristics,misdiagnosed causes and treatment methods of children with congenital kidney and ureter malformation combined with hydronephrosis. Methods Clinical data of 9 children with con-genital kidney and ureter malformation combined with hydronephrosis was retrospectively analyzed. Results Mainly clinical manifestations of these patients were waist and abdomen pain,fever and urinary irritation symptoms. Before operation,7 chil-dren were misdiagnosed as having hydronephrosis and 2 as having renal cyst. Pyonephrosis was found during kidney paracente-sis and nephrostomy in 4 children,and congenital kidney and ureter malformation combined with hydronephrosis was con-firmed;pus cells were found in intraoperative sample of turbid urine during pyeloureteroplasty,and the diagnosis was con-firmed;pyonephrosis was found during retrograde pyelography draining by intra-ureteral cannula under cystoscopes in 4 pa-tients,and the diagnosis was confirmed. All the 9 children underwent surgery,among whom 5 children underwent nephron sparing surgery,3 children underwent resection for pyonephrosis,and nephrostomy was performed for 1 patient with bilateral pyonephrosis associated by chronic renal insufficiency. Conclusion Clinical manifestations of congenital kidney and ureter malformation combined with hydronephrosis are lack of specific,and therefore it is easy to miss diagnosis and misdiagnosis. It is the key points for early diagnosis by performing B ultrasonography,intravenous urography,magnetic resonance urography, CT,diffusion weighting magnetic resonance imaging and retrograde radiography examination in time combined with medical history.