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Pediatric Laparoscopic Pyeloplasty of Pelvic Ectopic Kidney with UPJO - A Case Report |
| 양산부산대학교병원 비뇨의학과 |
| Kobiljon Ergashev, Jae Min Chung, Sang Don Lee |
Introduction
Renal ectopia occurs in 1:3,000-1:7,000 children. Pelvic ectopic kidney with hydronephrosis due to ureteropelvic junction obstruction (UPJO) is uncommon in clinical practice. We report a case of a pelvic ectopic kidney with hydronephrosis due to UPJO who performed laparoscopic pyeloplasty in a 3-year-old girl.
Case report
Renal abnormality was detected during the antenatal ultrasonography (USG). Postnatal USG KUB confirmed the ectopically located pelvic kidney on the left side with dilated extrarenal pelvis (APD=24 mm). Further imaging with DMSA at 7 weeks old checkup showed the relative function of left ectopic kidney as 27%. The next follow-up MAG3 renal scan was conducted at 5.5 months old and it revealed decreased left renal function (19.5%) without any signs of obstruction.
After that parents were recommended close follow-up with routine USG by pediatric nephrologist. Further follow-up USG studies were without any significant changes.
The patient was referred to pediatric urologist at 3 year old and follow-up DTPA showed significantly decreased relative function on the left (16.6%) with obstruction. We performed laparoscopic dismembered pyeloplasty. Postoperative USG after 3 months showed the significant improvement of pelvic dilation (8 mm). In conclusion, relying on just USG may not be enough to clinical decision making and timing of the management of the ectopic pelvic kidney in children. In spite of abnormal location and surgical challenges, laparoscopic dismembered pyeloplasty is safe and feasible in the reconstructive management of the ectopic pelvic kidney in children.
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keywords : Ectopic Kidney, UPJO, Pyeloplasty |
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