Kalabhavi Srinivas K.pdf

Clinical features:
Proforma
The presenting symptoms of UPJ obstructions have been documented to be
varied and somewhat age dependent.
Most infants are asymptomatic:
- In children younger than 1 year old, the most common presentation has been a
palpable abdominal mass 20,21 . Any palpable flank mass in an infant should raise
the question of HN, since 50% of all palpable abdominal masses in infants and
children are of renal origin 22 . Urinary tract infection was the presenting symptom
as often as a flank mass in a large series of patients of UPJ obstruction performed
by Johnston and colleagues 23 .
In older children, urinary tract infection (UTI) with fever has been reported to
be the most common presenting complaint (30%) 24 .
Other clinical presentations include,
Abdominal or flank pain.
Chronic nausea and vomiting
Hematuria following mild or unrecognized trauma (25%).
This hematuria is believed to be caused by disruption and rupture of mucosal
vessels in the dilated collecting system (Kelalis et al, 1971)
Hypertension:
The pathophysiology is thought to be a functional ischemia with reduced
blood flow caused by the enlarged collecting system that produces a renin-
mediated hypertension (Belman et al, 1968).
Failure to thrive.