Diagnostic difficulties in children with coexisting pelvi-ureteric and vesico-ureteric junction obstruction.
OBJECTIVE
To assess the diagnosis of children with coexisting pelvi-ureteric junction (PUJ) and vesico-ureteric junction (VUJ) obstruction, and the management of such patients, as having these two anomalies in the same ureter creates serious diagnostic difficulties, but any delay in diagnosis might cause a deterioration of renal function and affect the success of surgery to correct either anomaly.


METHODS
We assessed the diagnostic difficulties and approach to 14 patients with coexistent PUJ and VUJ obstruction, who were treated surgically in our clinic between 1994 and 2005; we also review related published reports in English.


RESULTS
Surgery was used in all 14 patients over the 11-year period; only five patients had an accurate diagnosis before surgery. Six patients were diagnosed with uroradiological techniques immediately after pyeloplasty; three were diagnosed on investigating an associated anomaly later.


CONCLUSIONS
In children with coexisting PUJ and VUJ obstruction there are serious diagnostic problems; to prevent any deterioration in renal function due to obstruction, these anomalies require early diagnosis and treatment. For an early and accurate diagnosis, the coexistence of these two anomalies in the same ureter should be considered.
Cay
Ali
A
Paediatric Surgery , Karadeniz Technical University Medical Faculty, Trabzon, Turkey. dralicay@yahoo.com
Imamoglu
Mustafa
M
Bahat
Elif
E
Sarihan
Haluk
H
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery; D008297:Male; D014517:Ureteral Obstruction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery