RESUMEN
Se presenta un caso de útero didelfo con hemivagina ciega y agenesia renal ipsilateral. Es una anomalía infrecuente del desarrollo de los conductos de Müller. El defecto en uno de los conductos de Wolf condiciona un fallo en la inducción de la formación renal y en la fusión de los conductos de Müller. La resonancia magnética desempeña un papel decisivo en el diagnóstico y caracterización de la malformación (AU)
We report a case of uterus didelphys with blind hemivagina and ipsilateral renal agenesis. This is an uncommon anomaly of the development of the Mullerian ducts in which a defect in one of the Wolffian ducts leads to failed induction in kidney formation and in the fusion of the Mullerian ducts. MRI plays a decisive role in the diagnosis and characterization of the malformation (AU)
Asunto(s)
Humanos , Femenino , Niño , Pelvis/patología , Quistes/diagnóstico , Genitales Femeninos/anomalías , Útero/anomalías , Vagina/anomalías , Hematocolpos/diagnóstico , Riñón/anomalías , Espectroscopía de Resonancia Magnética/métodos , Conductos Paramesonéfricos/anomalías , Conductos Mesonéfricos/anomalíasRESUMEN
We report a case of uterus didelphys with blind hemivagina and ipsilateral renal agenesis. This is an uncommon anomaly of the development of the Mullerian ducts in which a defect in one of the Wolffian ducts leads to failed induction in kidney formation and in the fusion of the Mullerian ducts. MRI plays a decisive role in the diagnosis and characterization of the malformation.
Asunto(s)
Anomalías Múltiples/diagnóstico , Anomalías Congénitas/diagnóstico , Quistes/congénito , Quistes/diagnóstico , Hematocolpos/diagnóstico , Enfermedades Renales/congénito , Riñón/anomalías , Imagen por Resonancia Magnética , Conductos Paramesonéfricos/anomalías , Anomalías Urogenitales/diagnóstico , Útero/anomalías , Vagina/anomalías , Niño , Quistes/complicaciones , Femenino , Hematocolpos/complicaciones , Humanos , Enfermedades Renales/complicaciones , Enfermedades Renales/diagnóstico , Anomalías Urogenitales/complicacionesRESUMEN
OBJECTIVE: Not all hospitals in our country have their own nuclear medicine laboratory. Most small and medium size hospitals must arrange their radioisotope studies with private clinics. The objective of this study was to assess if a single DMSA scan performed after an acute infection in a group of patients chosen according to certain risk criteria would allow the selection of those who run the risk of progressive renal damage. PATIENTS AND METHODS: A descriptive and retrospective study of the clinical records of 65 patients under 14 years of age with urinary tract infection (UTI) seen at our institution between 1994 and 1995 and on whom a DMSA scan had been performed was carried out. The study groups was formed by the fifteen children with scintigraphic findings compatible with renal scarring. The fifty children with normal DMSA scans were used as controls. RESULTS: Renal scarring was found more often in patients over one year of age (p < 0.05), in those with reinfections (p < 0.001) and in those kidneys with grade III vesicoureteral reflux (VUR, p < 0.05). The most severe lesions, with reduction of renal size, shape abnormalities and diminished uptake of the tracer were found together with VUR. The renal sonogram performed during the acute stage of the UTI was able to detect only four of the six children most severely affected. CONCLUSIONS: Delaying the practice of the DMSA scan until 6 months after the last episode of bacteriuria would allow selection of those patients at the highest risk of progressive renal damage. This guideline would reduce scintigraphic studies 30 to 90%, since it would avoid repeated studies in those children with abnormal findings in the acute stage. The practice of the radioisotope study only in a reduced subset of patients selected on the basis of risk criteria such as recurrent UTI, VUR or suspected pyelonephritis does not allow detection of all scars.
Asunto(s)
Infección Hospitalaria/diagnóstico por imagen , Radiofármacos , Ácido Dimercaptosuccínico de Tecnecio Tc 99m , Infecciones Urinarias/diagnóstico por imagen , Adolescente , Niño , Protocolos Clínicos , Humanos , Riñón/diagnóstico por imagen , Pielonefritis/diagnóstico por imagen , Cintigrafía , Estudios Retrospectivos , Factores de Riesgo , Ultrasonografía , Reflujo Vesicoureteral/diagnóstico por imagenRESUMEN
We present three cases of acute lobar nephronia or acute focal bacterial nephritis on paediatric patients. Both radiological and echographic pictures are described, emphasizing those aspects which, together with a clinical symptomatology, allow a differential diagnose with abscess and neoplasias renally settled. We think that, among those patients suffering from pyelonephritis, an early practice of renal echography followed by further controls, allow an early detection of lobar nephronia cases and assessing a response to the treatment.