Rodrigo Medorio
Children's Hospital of Mexico Federico Gómez
Title: Pediatric Hydronephrosis. What to do?
Biography
Biography: Rodrigo Medorio
Abstract
Introduction: 1-5% of obstetric ultrasound will show some degree of hidronephrosis and a high percentage of them will persist during the first decade of life or require surgical management. Prenatal hydronephrosis is define by an anterior-posterior diameter of the renal pelvis greater then or equal to 4mm at less then 33 weeks of gestation and 7mm at greater than 33 weeks gestation. In older children it is define as renal dilation with urine accumulation. Although a great number are considered transient or physiologic, the most common etiologies are ureteropelvic junction obstruction, vesicoureteral reflux and non-refluxing primary megaureter.
Objective: The purpose is to share a time saving evaluation and to optimize referral of patients detected with hidronephrosis so they may have an optimal etiological diagnosis and treatment.
Methods: A review of literature has been done to create a first line fallow-up algorithm for pediatric healthcare personnel. We reviewed literature from the last ten years selecting articles referring to diagnosis, classification and fallow-up. We excluded the ones focused on surgical treatment and management outcomes.
Results: It has been established an evidence based study algorithm for pediatric patients diagnosed with hydronephrosis and found that ultrasound is the corner stone in decision making for first line fallow-up of hydronephrosis and also marks the next step to take.
Conclutions: All patients diagnosed with hydronephrosis need to be monitored. Ultrasound is always the first exam in the decision making algorithm in the study of a hydronephrotic patient. Being the first line contact, it is imperative for pediatric health care professionals to have a knowledge of how to monitor this patient for an optimal referral.