ESPN 51th Annual Meeting

ESPN 2018


 
The value of ultrasound in young children with urinary tract infection
STROESCU RAMONA 2 GAFENCU MIHAI 2 DAVID VLAD 2 BIZEREA TEOFANA 2 ISAC RALUCA 2 MARGINEAN OTILIA 2 DOROS GABRIELA 2

1- "LOUIS TURCANU" EMERGENCY HOSPITAL FOR CHILDREN
2- "V. BABES" UNIVERSITY OF MEDICINE AND PHARMACY
 
Introduction:

Urinary tract infections (UTIs) have been considered to be the principal cause of permanent renal parenchymal damage and scarring in children. Vesicoureteral reflux (VUR) is found in 30% to 40% of children with UTI; reflux, especially of higher grades, increases the risk of recurrent UTIs and renal scarring, with associated sequelae in later life (proteinuria, hypertension, eclampsia and end-stage renal disease). Aim: Assessing the need to perform voiding urosonography as a screening method for VUR in young children with UTIs. 

Material and methods:

Renal ultrasounds were performed on 179 patients with UTIs hospitalized during April 2016 –December 2017. The patients were aged between 0.4 months – 10 years, with an average of 3 years ± 2.8 months. Of these, 109 patients (60.9%) had a normal renal ultrasound report. 

Results:

 Patients with history of more than 2 infections (58 patients -32.5%) underwent voiding urosonography. Secondary VUR due to posterior urethral valve was found in 6 patients. 32 patients had grade 3, 4 or 5 VUR, and were transferred to the surgery department. 15 (25.8%) patients had no pelvic or distal ureteral dilatation on renal ultrasound. In 5 patients VUR could not be detected. Discussions: Patients with no pelvic renal dilatation on ultrasound had a history of more frequent UTIs; normal ultrasound findings delayed exploring for VUR and establishing prevention treatment for UTIs

Conclusions:

 

Renal ultrasound is important in order to establish a complete diagnosis and monitoring of UTI in children. Voiding urosonography is a reliable, sensitive, safe and radiation-free method of investigation of VUR in children.