Christopher P. Coppola, Alfred P. Kennedy, Jr. and Ronald J. Scorpio (eds.)Pediatric Surgery2014Diagnosis and Treatment10.1007/978-3-319-04340-1_46
© Springer International Publishing Switzerland 2014
Ureteropelvic Junction Obstruction
(1)
Department of Pediatric Urology, Geisinger Medical Center, 100 N. Academy Av. MC 13-16, Danville, PA 17822, USA
(2)
Department of Pediatric Urology, Janet Weis Children’s Hospital, 100 N. Academy Av. MC 13-16, Danville, PA 17822, USA
Abstract
Pediatric ureteropelvic junction (UPJ) obstruction can occur in all age groups; increased detection in neonates due to prenatal hydronephrosis can be seen on ultrasonography. It is more common in boys than girls and more common on the left side.
Pediatric ureteropelvic junction (UPJ) obstruction can occur in all age groups; increased detection in neonates due to prenatal hydronephrosis can be seen on ultrasonography. It is more common in boys than girls and more common on the left side.
1.
Pathophysiology:
(a)
Causes of UPJ obstruction:
(i)
Intrinsic: interruption in development of circular musculature of the UPJ causing fibers to be widely separated and leading to functional discontinuity of muscular contractions, poor emptying; other causes include valvular mucosal folds or upper ureteral polyps.
(ii)
Extrinsic: aberrant, accessory, or early-branching lower pole vessel passing anteriorly to the UPJ.
(iii)
Secondary UPJ obstruction: severe VUR with tortuous course causing proximal kinking of ureter due to fixation causing obstruction.
(b)
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Associated anomalies:
(i)
