Professional Documents
Culture Documents
Agenesis
Bilateral renal agenesis is extremely rare.
The children don’t survive.
1
28/10/1443
Hypoplasia
2
28/10/1443
Diagnosis by U/S
3
28/10/1443
4
28/10/1443
Etiology &pathogenesis
Clinical findings
Symptoms
odrag pain by the heavy kidneys
oobstruction
oinfection
ohemorrhage into a cyst.
oColicy pain due to stones or clots
oGross or microscopic hematuria may occur.
oabdominal mass.
oInfection (chills, fever, renal pain)
oSymptums of renal failure
5
28/10/1443
Signs
•one or both kidneys are usually palpable.
-If infected they may be tender.
•Hypertension is found in 60-70% of these patients.
•Fever may be present if pyelonephritis exists or if
cysts have become infected.
•In the stage of uremia, anemia or loss of weight may
be evident.
Laboratory finding
6
28/10/1443
x-ray finding
Treatment
conservative & supportive (proflactive).
low protein diet
Good fluid intake
Physical activity is permitted but strenuous exercise
is contraindicated.
Hypertension should be controlled.
Renal failure should be treated by dialysis or renal
transplant.
A large cyst compressing upper ureter causing
obstruction should be excised or aspirated.
7
28/10/1443
CT scan is diagnostic
Clinical finding
•Pain in the flank or back, usually intermittent &
dull.cyst is usully symptmatic if it is 10cm and more
If bleeding occur pain may come on abruptly & be
sever.
•The patient may discover mass in the abdomen,
8
28/10/1443
Laboratory finding
Urinalysis is usually normal.
Renal function tests are normal.
CT scan
Appear to be the most accurate means of
differentiating renal cyst & tumor.
Differential diagnosis.
9
28/10/1443
Treatment
If the diagnosis can be clearly established, treatment
is follow up by ultrasonography.
.
Renal fusion
10
28/10/1443
Horseshoe Kidney
11
28/10/1443
Clinical features
x-ray finding
in case of horseshoe kidney
The renal mass lower than normal
-the axes of the 2 kidneys are vertical andparallel
-the renal pelves lie on the anterior surfaces of the
kidney masses,
-the most valuable clue to the diagnosis of horseshoe
kidney is the presence of calyces in the region of
lower pole point medially & lie medial to the ureter.
12
28/10/1443
Complications.
-Obstruction,
-hydronephrosis,
-stone
-infection
-tumour
Treatment.
No treatment is necessary unless obstruction or
infection is present.
Drainage may be improved by division of isthmus
If one pole is badly damaged it may require surgical
resection
13
28/10/1443
Ectopic kidney
Congenital ectopic kidney usually cause no symptoms
unless complications such as
uerteral obstruction or infection develop.
Simple ectopy
Refer to low kidney on the proper side that fail to
ascend normally.
It may lie over the pelvic brim or in the pelvis.
rarely it may find in the chest.
14