Complete ureteropelvic-junction disruption following renal trauma: conservative management.

Autor:	Oliver Vall-Llosera MB; Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain)., Gander R; Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain)., Royo Gomes G; Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain)., Aguilera Pujabet M; Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain)., Rocha Guzmán O; Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain)., López Paredes M; Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain)., Asensio Lorente M; Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery. Hospital Universitario Vall d'Hebron. Barcelona (Spain).
Jazyk:	English; Spanish; Castilian
Zdroj:	Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica [Cir Pediatr] 2024 Jul 09; Vol. 37 (3), pp. 141-144. Date of Electronic Publication: 2024 Jul 09.
DOI:	10.54847/cp.2024.03.18
Abstrakt:	Introduction: Surgical exploration in complete ureteropelvic-junction disruption (CUPJD) is still recommended by many authors. Conservative approach to pediatric renal trauma (RT) includes minimally invasive techniques such as nephrostomy, angioembolization or double-J stent placement. Case Report: A 14-year-old patient with CUPJD was treated conservatively. CT-scan revealed active bleeding of the renal artery and significant urine extravasation. Coil angioembolization and nephrostomy placement were performed. An attempt to place a double-J stent was unsuccessful and surgical reconstruction was scheduled. Before surgery, methylene-blue was injected through the nephrostomy observing blue urine output through urethra. Antegrade pyelogram revealed drainage from the urinoma to the ureter. A new attempt to place an internal-external double-J-stent was successful. After 5 weeks, it was removed with total restoration of the urinary tract. Conclusion: Complete urinary tract restoration in some cases of CUPJD following RT is possible through a nonoperative approach. It can be safe and effective, reducing the risk of complications associated with complex surgeries.
Databáze:	MEDLINE
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