Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury abdomen with haematuria following fall from motorcycle. He had pallor, and features of hypovolumic shock and peritonitis. Skiagram of the abdomen showed haziness of the abdomen, without free gas under diaphragm. u ltrasonography ( u SG) of the abdomen revealed significant hemoperitoneum and gross hydronephrosis of the left kidney, which was undiagnosed previously. Exploratory laparotomy was done for peritonitis and the findings were hemoperitoneum, hematoma at the left mesocolon and left retroperitoneum. Postoperative computed tomography (CT) scan of the abdomen reported left hydronephrosis due to pelvi-ureteric junction (P u J) obstruction with rupture of the renal pelvis. The ruptured hydronephrotic kidney was successfully managed by nephrostomy followed by delayed open dismembered Anderson-Hynes pyeloplasty. His postoperative recovery following pyeloplasty was uneventful and he was doing well at follow-up after a month of pyeloplasty.
展开▼
机译：在评估儿童有或没有血尿的肾脏和腹部钝性损伤的评估过程中，经常发现先天性，隐匿性先天性肾脏异常。这是一个7岁男孩的报告;从摩托车摔倒后出现腹部钝伤并伴有血尿。他面色苍白，并伴有低容量性休克和腹膜炎。腹部的裙状图显示腹部浑浊，隔膜下方没有游离气体。腹部的超声检查（u SG）显示明显的腹膜血肿和左肾的严重肾积水，这是以前无法诊断的。对腹膜炎进行了探索性剖腹手术，发现的是腹膜出血，左中结肠和左腹膜后的血肿。腹部的术后计算机断层扫描（CT）扫描报告由于骨盆-输尿管结（P u J）阻塞并伴有肾盂破裂而导致左肾积水。肾造口术成功治疗了破裂性肾积水，随后进行了开放肢解的安德森-海恩斯肾盂成形术。肾盂成形术后他的术后恢复平稳，在一个月的肾盂成形术后，他的随访情况良好。
展开▼
