title: [Intermittent hydronephrosis in childhood].
abstract: BACKGROUND
  Intermittent pelviureteric junction obstruction, and its consequence,intermittent hydronephrosis is a difficult condition to identify. The renal collecting system is not dilated between the episodes of abdominal pain attacks and a prompt investigation is hard to carry out during the time of painful crisis. Therefore, most of the patients are initially misdiagnosed.
  
  
  OBJECTIVE
  The aim of the study was to assess the occurrence and the clinical characteristics of this phenomenon in children operated in the Department of Urological Surgery, Heim Pál Children Hospital, Budapest, Hungary.
  
  
  METHODS
  Medical records of children operated for hydronephrosis between 2008 and 2012 were reviewed. The occurrence rate and clinical features of intermittent hydronephrosis were analyzed.
  
  
  RESULTS
  76 children were operated for pelviureteric junction obstruction, of which 10 met the criteria of intermittent hydronephrosis. The average interval between the onset of symptoms and the final diagnosis was 2 years and 4 months. In 7 patients pyeloplasty, and in 3 patients nephrectomy were performed.
  
  
  CONCLUSIONS
  Intermittent hydronephrosis represents a well-defined proportion among cases operated for hydronephrosis. The delay in diagnosis led to the loss of the kidney in one third of the patients, and this finding urges for the awareness of health professionals for this phenomenon. In case of recurrent abdominal pain of unknown etiology one must suspect a urological origin, even if a previous abdominal ultrasound showed normal kidneys.
authors.affiliation: Heim Pál Gyermekkórház, Urológiai Sebészeti Osztály, Budapest. merksz@heimpalkorhaz.hu
authors.forename: Miklós
authors.initials: M
authors.lastname: Merksz
authors.forename: Bálint
authors.initials: B
authors.lastname: Sulya
authors.forename: Mária
authors.initials: M
authors.lastname: Polovitzer
authors.forename: Ildikó
authors.initials: I
authors.lastname: Héjj
authors.forename: Diana
authors.initials: D
authors.lastname: Molnár
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szepesváry
authors.forename: András
authors.initials: A
authors.lastname: Kiss
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002648:Child; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D021501:Flank Pain / Q000209:etiology; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D006869:Hydronephrosis / Q000150:complications / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000175:diagnosis / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000601:surgery