By D. Innes Williams M. D., M. Chir. (Cantab), F. R. C. S. (Eng.) (auth.)
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Extra info for Urology in Childhood
The diagnosis is usually apparent from a consideration of the clinical findings and family history, and it may be confirmed by pyelography, though it must be remembered that where the cysts are small, the deformity will be slight (Fig. 12). Treatment is chiefly concerned with the management of the failing kidney and surgery is seldom required. Certain reported cases of bilateral polycystic disease present variants on one or other of the two forms described. Thus SMITH and GRAHAM describe a Fig.
During the attack there is a severe loin pain which does not radiate; it lasts for some hours and is accompanied by vomiting and paIlor, but after its cessation the child is weIl and symptom-free. In the younger children the pain is less wen localized and may be referred to the central abdomen, leading perhaps to the diagnosis of appendicitis. In the pelvic ectopic kidney, hydronephrosis may cause lower abdominal pain. At times vomiting is the predominant feature, and such cases are often regarded as examples of the "periodic syndrome" or acidosis.
The acute form is the more common and is seen chiefly in children over the age of 5 years. During the attack there is a severe loin pain which does not radiate; it lasts for some hours and is accompanied by vomiting and paIlor, but after its cessation the child is weIl and symptom-free. In the younger children the pain is less wen localized and may be referred to the central abdomen, leading perhaps to the diagnosis of appendicitis. In the pelvic ectopic kidney, hydronephrosis may cause lower abdominal pain.