Bose Sumona, Iyengar Arpana, Shubha Attibele Mahadevaiah
St. John's National Academy of Health Sciences, Bengaluru, India.
Department of Pediatric Surgery, Bengaluru, India.
Front Pediatr. 2022 Aug 11;10:933948. doi: 10.3389/fped.2022.933948. eCollection 2022.
Although pediatric urolithiasis is an established entity, its antenatal diagnosis is rare. We hereby report a case detected at 20 weeks gestation and discuss the etiopathogenesis, predisposition, and surveillance following intervention.
A 2-year-old girl with left renal pelvic calculus detected antenatally at 20 weeks was evaluated. Left hydronephrosis, obstructive pelvic calculus with a decrease in differential renal function on ethylene dicysteine (EC) renogram was confirmed. The metabolic workup was normal. Following stone extraction by left pyelolithotomy, a left ureteropelvic junction obstruction secondary to a mucosal valve was apparent which was excised and left pyeloplasty was done. Stone analysis revealed 100% cystine. Differential renal function and drainage improved post-surgery. The child, however, did not have a follow-up in the interim and presented with a recurrent stone one and a half years later.
Knowledge of antenatal urolithiasis ensures continued follow-up, evaluation for metabolic disorders, and associated structural defects, especially with increasing stone size and increasing hydronephrosis. This helps in timely intervention and continued surveillance.
尽管小儿尿路结石是一种已明确的病症，但其产前诊断却很罕见。我们在此报告一例在妊娠20周时检测出的病例，并讨论其病因、易患因素以及干预后的监测情况。
对一名2岁女孩进行了评估，她在产前20周时被检测出左肾盂结石。经证实存在左肾积水、梗阻性肾盂结石，且二巯基乙烷（EC）肾图显示患侧肾功能有所下降。代谢检查结果正常。通过左肾盂切开取石术后，发现继发于黏膜瓣的左输尿管肾盂连接处梗阻，遂将其切除并进行了左肾盂成形术。结石分析显示结石成分100%为胱氨酸。术后患侧肾功能及引流情况有所改善。然而，在此期间该患儿未进行随访，一年半后出现复发性结石。
了解产前尿路结石情况可确保持续随访、评估代谢紊乱及相关结构缺陷，尤其是在结石增大和肾积水加重的情况下。这有助于及时进行干预和持续监测。
