Lower pole ureteral obstruction secondary to fecal impaction in an 8-year-old girl.
An 8-year-old girl presented with frequent, nonfebrile, urinary tract infections and a lifelong history of severe constipation. Ultrasound revealed bilateral duplicated renal systems, severe right upper pole hydronephrosis, and moderate left lower pole hydronephrosis. Computerized tomographic scan revealed a large, fecal-impacted colon. Diuretic renogram showed high-grade obstruction (T1/2 >30 minutes) of the right upper pole and left lower pole moieties. After administering an aggressive bowel preparation, a repeat diuretic renogram was performed, which revealed resolution of the left lower pole obstruction. Constipation has long been established as a contributing factor to urinary tract infections in children. However, fecal impaction causing ureteral obstruction in a child has not been reported. We report the case of an 8-year-old girl who had left lower pole ureteral obstruction secondary to fecal impaction.
Paquette
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Urology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Peppas
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D002648:Child; D004573:Electrolytes / Q000627:therapeutic use; D005244:Fecal Impaction / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D011092:Polyethylene Glycols / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014517:Ureteral Obstruction / Q000209:etiology* / Q000628:therapy; D014552:Urinary Tract Infections / Q000209:etiology
D004573:Electrolytes; C033608:Golytely; D011092:Polyethylene Glycols