Biomedical subjects
Publications and source records attributed to A F Azmy.
We describe an unusual case of pelviureteric junction obstruction in a child due to a benign ureteric polyp. Benign neoplasms of the ureter are uncommon in adults and extremely rare in children.
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This is a report on a 5-year-old boy with dorsal penile angulation without epispadias. The surgical correction is described.
Skin chordee is a congenital abnormality due to failure of development of the mesenchyme surrounding the primitive urethra. It is frequently misdiagnosed as hypospadias. We describe the presentation and surgical management of 12 patients who presented to this hospital over the past 3 years.
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The aim of this study was to assess 2 groups of children with spina bifida; one with and the other without upper renal tract (URT) changes at birth and to evaluate the outcome of their management. In Group 1, there were 148 patients who had normal URT at birth. They were studied for a mean follow-up of 131 months. Twenty-eight per cent developed URT changes in later life. The median time interval for URT changes to develop between birth and the first assessment which showed abnormal finding, was 33 months and between the last normal URT assessment and the development of URT changes, was 16 months. Six patients with URT changes were treated conservatively and 36 required intervention. Twenty-eight of 42 patients showed initial improvement of URT changes but 25 subsequently deteriorated. In 3 patients renal function deteriorated with renal failure in one and renal impairment in 2. In Group 2, 24 patients who had URT changes present at birth were also studied for a mean follow-up of 115 months. The URT changes in 8 patients deteriorated after the initial assessment over a median time of 15 months. Twelve patients' URT changes improved spontaneously without active intervention over a median time interval of 16 months but 5 subsequently deteriorated. Overall, the prognosis of children with URT changes at birth did not seem to be any worse than children developing changes later in life. Lesions of sacral and thoraco-lumbar regions of the spine were most commonly associated with URT changes.(ABSTRACT TRUNCATED AT 250 WORDS)
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An infant is reported with complete duplication of the colon, rectum, anus, terminal ileum up to the point of Meckel's diverticulum, doubling of the genitalia with completely formed penes, double bladder and urethra, multiple spinal anomalies, omphalocele, and large lower abdominal wall hernia with wide separation of the symphysis pubis.
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OBJECTIVE: To assess the value of antenatal diagnosis of abnormalities of the urinary tract on ultrasonography. DESIGN: Retrospective study. SETTING: Two obstetric units in Glasgow. SUBJECTS: 62 Fetuses in which renal abnormalities were diagnosed on antenatal ultrasonography. INTERVENTIONS: Six fetuses had their bladders aspirated to determine renal function. Fifteen pregnancies were terminated on the basis of the findings on antenatal ultrasonography, and if possible necropsy was performed on the fetuses. In babies who were born alive the final diagnosis was made by postnatal ultrasonography, intravenous urography, radionuclide scanning, cystography, and, in those who died in the early neonatal period, necropsy. Neonates who were referred with a known obstructed kidney had nephrostomy or pyeloplasty. END POINT: Assessment of the value of antenatal diagnosis of renal abnormalities on ultrasonography for babies who had no clinical evidence of disease postnatally. MAIN RESULTS: Eighteen fetuses did not survive birth; the antenatal diagnosis was accurate in all 18. Of the 44 babies born alive, five had normal urinary tracts, in two of whom antenatal ultrasonography had probably indicated a false positive diagnosis. Fourteen babies died during the early neonatal period. Twenty five babies with renal abnormalities were followed up; the antenatal diagnosis was inaccurate for 10 of them, the commonest misdiagnosis being hydronephrosis for multicystic kidney and vice versa, and there was one false positive diagnosis. The initial clinical findings in 14 babies would have led to the early detection of a urological abnormality. In the 30 babies with no clinical evidence of disease the antenatal diagnosis was of definite value in eight, probable value in 15, and marginal value in seven. Overall, an accurate antenatal diagnosis was made in 46 of the 62 cases (74%); in 12 cases renal disease was detected but its specific nature was not determined; and in four cases the diagnosis was misleading. CONCLUSIONS: The overall value of antenatal diagnosis is that it indicates early termination of fetuses with fatal renal disease, prepares parents and medical staff for the likelihood of serious neonatal problems, and shows abnormalities of the urinary tract that may not be detected postnatally.
A case of a 12-year-old boy with tuberous sclerosis who developed life-threatening hematuria is presented. An angiomyolipoma of the lower two thirds of the left kidney resulted in a tumor hemorrhage that was successfully treated by partial nephrectomy.
We report the anomaly of intrarenal duplication seen during the course of investigation of urinary tract infection in 6 children. The anomaly and its embryological basis are described.
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Eight infants with hemangiomata associated with severe consumption coagulopathy are reviewed; three died. The presentations and method of management are discussed. The varied response to different modalities of therapy initiated this report and led to a search of the world literature in an attempt to identify the pattern of response, if any, to particular therapy. From our own experience with two cases and from the review of the literature, it appears that radiotherapy alone or in combination with steroids gives a superior overall treatment in terms of reducing the death rate.
Six children with shunt nephritis are reported of whom two did not show complete recovery of renal function. Follow up and outcome in relation to the delay in diagnosis and renal biopsy appearances are discussed.
Leaving babies and young children out in the sun during periods of unexpected exceptionally fine weather resulted in 142 children being treated for sunburn in the Royal Hospital for Sick Children in Glasgow over a 6-year period. Care-givers should be warned of the potential hazards of overexposure to sunshine.