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Chapter: Paediatrics: Nephrology

Paediatrics: Abdominal/renal mass

A rare presentation of urinary tract problems, which needs to be differen-tiated from other causes of abdominal mass and swelling.

Abdominal/renal mass

 

A rare presentation of urinary tract problems, which needs to be differen-tiated from other causes of abdominal mass and swelling.

 

Causes

 

Intrarenal

 

Wilms’ tumour (young child with rapidly growing mass).

 

Renal venous thrombosis (newborn with haematuria).

 

Benign nephroma (rare neonatal problem).

 

Horseshoe kidney.

 

Pyelonephritis (renal abscess).

 

Other renal

 

Hydronephrosis associated with the following.

Pelviureteric junction (PUJ) obstruction.

Vescioureteric junction (VUJ) obstruction.

Large bladder and bladder outlet obstruction: e.g.

o posterior urethral valves (PUV);

o prune belly syndrome;

o neurogenic bladder.

Urinoma: i.e. an encapsulated extrapelvicalyceal collection of urine that forms from urine leakage through a tear in the collecting system or the proximal ureter.

Single cyst (benign renal cyst).

Multicystic dysplastic kidney—usually newborn.

Polycystic disease:

o autosomal recessive;

o autosomal dominant—rare in children.

Haematoma (trauma).

 

Extrarenal

Adrenal mass (e.g. neuroblastoma).

 

Investigation

 

US will distinguish between most of the above.

Further investigation, depending on likely causes and discussion with radiology and urology colleagues, e.g. CT, MRI.

 

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Paediatrics: Nephrology : Paediatrics: Abdominal/renal mass |


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