Ureteropelvic junction obstruction and calyceal diverticulum in a child with Turner syndrome and horseshoe kidney |
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| Authors: | Florian Obermayr Philipp Szavay Jürgen Schäfer Jörg Fuchs |
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| Institution: | 1. Department of Pediatric Surgery, University of Tuebingen, Tuebingen, Germany;2. Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany;1. Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, China;2. Department of Urology, Lihuili Hospital, Ningbo Medical Center, China;3. Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, China;4. Department of Urology, Lihuili Hospital, Ningbo Medical Center, Affiliated Hospital of Medical School of Ningbo University, Ningbo, China;5. Department of Radiology, Lihuili Hospital, Ningbo Medical Center, China;6. Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China;1. Department of Pediatric Urology, Children''s Hospital Colorado, Division of Urology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado;2. Department of Pediatric Urology, Rady Children''s Hospital of San Diego, Department of Urology, University of California San Diego School of Medicine, San Diego, California;3. Department of Urology, University of Virginia School of Medicine, Charlottesville, Virginia;1. Department of Pediatric Urology, Children''s Healthcare of Atlanta and Emory University, Atlanta, GA, USA;2. Department of Radiology, Children''s Healthcare of Atlanta and Emory University, Atlanta, GA, USA;1. School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, Australia;2. Genesis CancerCare Queensland, The Wesley Medical Centre, Suite 1, 40 Chasely St, Auchenflower, QLD 4066, Australia;1. Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA;2. Department of Oncology, Johns Hopkins School of Medicine, 401 North Broadway, Baltimore, MD 21287, USA;3. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA;4. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA;1. Animal & Grassland Research and Innovation Centre, Teagasc, Moorepark, Co., Cork, Ireland;2. Reprodoc Ltd., Fermoy, Co., Cork, Ireland;3. Irish Cattle Breeding Federation, Bandon, Co., Cork, Ireland |
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| Abstract: | Laparoscopic dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction is considered to be a routine procedure in many pediatric surgical centers. UPJ obstruction is known to be associated with horseshoe kidney and several reports on successful laparoscopic repair in such cases exist.The case of a 9-month-old girl with Turner syndrome is reported. A horseshoe kidney with grade 4 hydronephrosis on the left side was diagnosed by ultrasound during the neonatal period. MAG3 diuretic renography and dynamic magnetic resonance imaging nephrography revealed a differential renal function of 31% and 69% on the left and right side, respectively. No drainage from the left renal pelvis could be demonstrated.Laparoscopy showed a combined UPJ obstruction and a calyceal diverticulum with a narrow infundibulum of the upper pole calices on the left side of the horseshoe kidney. Laparoscopic dismembered pyeloplasty and an additional infundibulopelvic anastomosis was performed. No intraoperative complications occurred. The immediate postoperative course was uneventful. Unobstructed drainage and stable differential renal function on the left side could be demonstrated on MAG3 diuretic renography 6 weeks postoperatively.In conclusion, laparoscopic repair of complex malformations of the upper urinary tract is feasible and leads to good functional outcome in selected cases. |
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