Othman Tan Suria Emilia Suhana, Mohamad Siti Dayana, Ahmad Muhamad Zabidi
Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia.
School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
Oxf Med Case Reports. 2021 Feb 15;2021(2):omaa132. doi: 10.1093/omcr/omaa132. eCollection 2021 Feb.
Hypertensive emergency in the paediatric population is not uncommon. However, due to its numerous etiologies, care should be taken in determining the approach of management. We report a case of a child who presented with double vision, giddiness and elevated blood pressure. Blood investigations were normal. Renal ultrasound and magnetic resonance imaging of the abdomen were performed which both showed findings suspicious of a large heterogeneous mass at the lower pole of the left kidney with dysplastic right kidney. A final diagnosis of bilateral vesicoureteric reflux with left compensatory hypertrophy was made based upon micturating cystourethrography findings and was later confirmed by 99mTc-dimercaptosuccinic acid (DMSA) study. The objective of this case is to share the importance of the appropriate choice of radiological examinations, not only in achieving an accurate diagnosis but to ensure that unnecessary investigations are avoided.
小儿高血压急症并不罕见。然而，由于其病因众多，在确定治疗方法时应谨慎。我们报告一例患儿，出现复视、头晕和血压升高。血液检查正常。进行了肾脏超声和腹部磁共振成像检查，两者均显示左肾下极有一个可疑的巨大不均匀肿块，右肾发育异常。根据排尿性膀胱尿道造影结果最终诊断为双侧膀胱输尿管反流伴左肾代偿性肥大，后来经99m锝-二巯基丁二酸（DMSA）研究证实。本病例的目的是分享正确选择放射学检查的重要性，这不仅有助于准确诊断，还能避免不必要的检查。
