XXXX by @entity8 : clinical and imaging features.

@entity1 @entity8 @entity455 @entity390 @entity391 @entity3041 @entity158 @entity293 @entity4145
OBJECTIVE: To present the characteristic clinical and imaging findings of pelvi-ureteric junction (PUJ) obstruction caused by @entity8 ( @entity8 ), as it presents particular features within the spectrum of congenital @entity3041 . @entity1 AND METHODS: Between April 1982 and December 2000, 384 @entity1 underwent surgery for PUJ obstruction. In 71 (18.5%; mean age 8.5 years, range 2 months to 14 years; 49 aged> 5 years), the obstruction was caused by @entity8 . The data collected from the medical records of these @entity1 were analysed for their clinical presentation and imaging findings, i.e. ultrasonography (US), intravenous urography (IVU) and diuretic renography. RESULTS: The main presenting symptom was recurrent renal colic ( @entity158 , @entity390 , @entity391 ) in 59%, followed by @entity293 ( @entity293 ) in 20%, gross haematuria in 11% and an incidental diagnosis in 10%. By contrast, in the 313 @entity1 with @entity4145 was present in only 10.5%. Moreover, from 1991 to 2000, when the use of prenatal US became widespread, @entity3041 was detected prenatally in 42 of 212 @entity1 (20%) with @entity4145 , but in only two of 31 (6%) with obstruction by @entity8 . However, in 10 @entity1 with @entity8 operated on during this period, prenatal US had shown mild @entity3041 (< 15 mm), which during the follow-up decreased until the @entity1 became symptomatic after 5-9 years (eight renal colic, two @entity293 ). US during acute symptoms showed significant @entity3041 (> 25 mm), and colour Doppler US of two @entity1 directly showed the @entity8 . In all 71 @entity1 with @entity8 and renography during the acute symptoms had an obstructive pattern, and in 24 renal colic was reproduced during the examination. The differential kidney function was < 40% in 11 @entity1 who presented with @entity293 ; two required nephrectomy and in the remaining 69 an Anderson-Hynes pyeloplasty, after which none had an episode of renal colic or @entity293 during a mean (range) follow-up of 10.2 (2-20) years. CONCLUSIONS: PUJ obstruction by @entity8 should be suspected in older @entity1 presenting with recurrent renal colic and @entity3041 . Good kidney function is expected in most of these @entity1 , despite their age, because the @entity455 is intermittent. Mild prenatal @entity3041 that could decrease postnatally does not exclude the possibility of @entity455 , which may later become symptomatic. Imaging (US, diuretic IVU and renography) during an episode of @entity158 is essential and colour Doppler US could help to establish the diagnosis in these cases. Knowing that a @entity1 has a @entity8 is important for choosing an open surgical approach rather than endoscopic pyelotomy, to avoid potential complications
