Correlation between pre-surgical imaging findings and intraoperative findings in children with duplex collecting system

Correlation between pre-surgical imaging findings and intraoperative findings in children with duplex collecting system

Catalina García-Stacey 1 , Abraham A. Chams-Anturi 1, 2 , Natalia Herrera-Toro 1 , Mónica R. Royero-Arias 1, 3 , Óscar A. Villada-Ochoa 1, 3 , Manuel A. Vélez 1 , Carolina Serna-Rojas 1

1 Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia; 2 Infantil San Vicente Fundación, Medellín, Antioquia, Colombia; 3 Hospital Infantil San Vicente Fundación, Medellín, Antioquia, Colombia

*Correspondence: Carolina Serna-Rojas, Email not available

Abstract

Objective: To determine the relationship between diagnostic imaging and surgical findings in children with duplex collecting system.

Method: Descriptive study of data from retrospective search for clinical records and diagnostic imaging of patients under 15 years old who underwent surgery for the treatment of double collecting system in the Pediatric Surgery Department at Hospital San Vicente Fundación between 2012 and 2022.

Results: Eighty-one patients who had preoperative diagnostic imaging and were operated on for a double collecting system were included. Sixty-three percent were female. The median age at surgery was 3 years. Functional uroresonance was the imaging modality with the highest sensitivity, correlating with the intraoperative finding of a double collecting system in 100% of the patients who underwent the image study. In surgery, a complete collecting system was found in 69% of the patients, incomplete in 30,8%, bilateral in 13%; urinary tract dilation in 38,2%, ureterocele in 25,9%, ectopic ureter insertion in 20,9%, and ureteral obstruction in 13.5% of the cases.

Conclusions: The diagnosis of a double collecting system is frequently associated with recurrent urinary infections. The initial test generally used was renal ultrasound. Voiding cystourethrography and uroresonance showed better anatomical and functional diagnostic approximation. The double collecting system is associated with other urinary tract anomalies, the most common being urinary tract dilation, vesicoureteral reflux, and ureterocele.

Keywords: CAKUT. Duplex renal collecting system. Vesicoureteral reflux. Ureteral obstruction. Diagnostic imaging. Surgery. Pediatrics.

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