Kamaraj Senthil G, Kochunny Ashita, Kathirvelu Gopinathan, Singh Praachi, Samnakay Naeem
Consultant Paediatric Urologist, Kanchi Kamakoti Child's Trust Hospital, 12-A, Nageswara Road, Nungambakkam, Chennai 600034, India.
Registrar in Paediatric Surgery, Kanchi Kamakoti Child's Trust Hospital, India.
Case Rep Urol. 2020 Aug 20;2020:8883546. doi: 10.1155/2020/8883546. eCollection 2020.
There are various causes of Reno Vascular Hypertension in children reported in the literature. Amongst these, Page kidney gets a rare mention. This phenomenon is a result of the accumulation of blood or urine in the perinephric or subcapsular space, resulting in compression of renal parenchyma, microvascular ischemia, alteration in the renin-angiotensin apparatus, and high renin hypertension. It has been well documented and studied in adults. Only a few cases are reported in the paediatric population. We report a rare presentation of Page kidney in a 5 year 8 months old girl. She initially presented with Dietl's crisis secondary to left Pelviureteric Junction obstruction (PUJO) causing massive hydronephrosis. She developed Page kidney phenomenon after spontaneous rupture of the pelvicalyceal system formed a tight compressive urinoma. She was managed successfully with internal JJ stenting and ultrasound-guided aspiration of the urinoma followed by elective delayed Pyeloplasty. To our knowledge, this is the first documented case of Page kidney in a child with severe PUJO.
文献报道了儿童肾血管性高血压的多种病因。其中，佩奇肾很少被提及。这种现象是肾周或肾包膜下间隙血液或尿液积聚的结果，导致肾实质受压、微血管缺血、肾素 - 血管紧张素系统改变以及高肾素性高血压。它在成人中已有充分记录和研究。儿科人群中仅报道了少数病例。我们报告了一名5岁8个月大女孩罕见的佩奇肾表现。她最初因左肾盂输尿管连接部梗阻（PUJO）继发Dietl危象，导致巨大肾积水。肾盂肾盏系统自发破裂形成紧密压迫性尿瘤后，她出现了佩奇肾现象。通过置入输尿管支架及超声引导下抽吸尿瘤，随后择期进行延迟肾盂成形术，她得到了成功治疗。据我们所知，这是首例有严重PUJO的儿童佩奇肾病例记录。
