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Paediatrics: Abdominal/renal mass
2021-03-04 12:00 AM
A rare presentation of urinary tract problems, which needs to be differentiated from other causes of abdominal mass and swelling.
Abdominal/renal mass
A rare presentation of urinary tract problems, which needs to be differentiated from other causes of abdominal mass and swelling.
Causes
Intrarenal
- Wilms’ tumour (young child with rapidly growing mass).
- Renal venous thrombosis (newborn with haematuria).
- Benign nephroma (rare neonatal problem).
- Horseshoe kidney.
- Pyelonephritis (renal abscess).
Other renal
Hydronephrosis associated with the following.
- Pelviureteric junction (PUJ) obstruction.
- Vescioureteric junction (VUJ) obstruction.
- Large bladder and bladder outlet obstruction: e.g.
o posterior urethral valves (PUV);
o prune belly syndrome;
o neurogenic bladder.
- Urinoma: i.e. an encapsulated extra pelvicalyceal collection of urine that forms from urine leakage through a tear in the collecting system or the proximal ureter.
- A single cyst (benign renal cyst).
- Multicystic dysplastic kidney—usually newborn.
- Polycystic disease:
o autosomal recessive;
o autosomal dominant—rare in children.
- Haematoma (trauma).
Extrarenal
Adrenal mass (e.g. neuroblastoma).
Investigation
- US will distinguish between most of the above.
- Further investigation, depending on likely causes and discussion with radiology and urology colleagues, e.g. CT, MRI.