The importance of ultrasonography examination in renal abscesses in pediatric patients

Authors

  • Katarzyna Kowalczyk Institute of Medical Sciences, Medical College of Rzeszów University; Clinical Department of Radiology and Diagnostic Imaging, Clinical Provincial Hospital No. 2 Saint Jadwiga Queen in Rzeszów, Poland https://orcid.org/0009-0004-9202-6917
  • Katarzyna Ożóg Institute of Medical Sciences, Medical College of Rzeszów University; Clinical Department of Radiology and Diagnostic Imaging, Clinical Provincial Hospital No. 2 Saint Jadwiga Queen in Rzeszów, Poland https://orcid.org/0009-0007-4272-9376
  • Joanna Klęba Institute of Medical Sciences, Medical College of Rzeszów University; Clinical Department of Radiology and Diagnostic Imaging, Clinical Provincial Hospital No. 2 Saint Jadwiga Queen in Rzeszów, Poland https://orcid.org/0000-0003-1147-1820
  • Iwona Kucharska-Miąsik Clinical Department of Radiology and Diagnostic Imaging, Clinical Provincial Hospital No. 2 Saint Jadwiga Queen in Rzeszów, Poland
  • Anna Guzik Institute of Medical Sciences, Medical College of Rzeszów University; Pediatric Surgery and Urology Clinic, Clinical Provincial Hospital No. 2 Saint Jadwiga Queen in Rzeszów, Poland
  • Wiesław Guz Institute of Medical Sciences, Medical College of Rzeszów University; Clinical Department of Radiology and Diagnostic Imaging, Clinical Provincial Hospital No. 2 Saint Jadwiga Queen in Rzeszów, Poland https://orcid.org/0000-0002-1309-5374

DOI:

https://doi.org/10.15584/ejcem.2024.3.18

Keywords:

pediatrics, renal abscess, ultrasonography

Abstract

Introduction and aim. Renal abscess is a rare finding in the pediatric population, estimated at 0.2% of all intra-abdominal abscesses. The most common manifestations are fever, flank pain and simultaneously increased inflammatory markers in laboratory tests. Symptoms of this condition are non-specific and can be dismissed with other pathologies like renal tumor. Although the management is based on widespread antibiotic therapy, some cases need surgical intervention because of poor general condition and major diameter of abscess (>5 cm). We undertook this study to analyze the ultrasonography findings correlated with the clinical manifestations of renal abscesses in children that can potentially improve detecting renal abscesses in children earlier.

Material and methods. We retrospectively studied 9 patients with renal abscesses treated in our hospital.

Results. All patients were diagnosed with renal abscesses based on ultrasonography (US) examination and each of them had elevated inflammatory parameters at the time of admission. For treatment, all patients were treated with intravenous antibiotics and two of them were treated with surgical drainage. All study group recovered completely or received a reduction of abscesses diameters. The renal abscesses were monitored by ultrasonography.

Conclusion. In our study, we assessed the usefulness of the US examination for diagnosis and treatment monitoring in pediatric patients. Ultrasonography is a gold standard due to its wide availability, noninvasiveness and low price. It also allows for immediate diagnosis, which is crucial to institute proper treatment. Treatment of abscesses depends on the clinical condition of the patient, other comorbidities, imaging presentation and the size of the abscess.

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References

Comploj E, Cassar W, Farina A, et al. Conservative management of paediatric renal abscess. J Pediatr Urol. 2013;9(6 Pt B):1214-1217. doi: 10.1016/j.jpurol.2013.05.016

Buschel H, Leung P, Stalewski H, Carroll D, Mariyappa-Rathnamma B. Renal abscesses in children: an 11-year retrospective study and review of the literature. ANZ J Surg. 2022;92(12):3293-3297. doi: 10.1111/ans.17943

Jaik NP, Sajuitha K, Mathew M, et al. Renal abscess. J Assoc Physicians India. 2006;54:241-243.

Coelho RF, Schneider-Monteiro ED, Mesquita JLB, et al. Renal and perinephric abscesses: analysis of 65 consecutive cases. World J Surg. 2007;31(2):431-436. doi: 10.1007/s00268-006-0162-x

Xia M, Liu J, Hong Y, et al. Renal Abscess: Invasive Treatment or not. https://www.researchsquare.com/article/rs-56366/v1. Accessed December 29,2023.

Seguias L, Srinivasan K, Mehta A. Pediatric renal abscess: a 10-year single-center retrospective analysis. Hosp Pediatr. 2012;2(3):161-166. doi: 10.1542/hpeds.2012-0010

Linder BJ, Granberg CF. Pediatric renal abscesses: A contemporary series. J Pediatr Urol. 2016;12(2):99.e1-99.e5. doi: 10.1016/j.jpurol.2015.05.037

Martonosi ÁR, Pázmány P, Fukász A, et al. Differential diagnostic challenges in the COVID-19 pandemic: renal abscess after SARS-CoV-2 infection in a young adolescent. Am J Case Rep. 2022;23:e935190. doi: 10.12659/AJCR.935190

Chen CY, Kuo HT, Chang YJ, et al. Clinical assessment of children with renal abscesses presenting to the pediatric emergency department. BMC Pediatr. 2016;16(1):189. doi: 10.1186/s12887-016-0732-5

Zhang X, Xie Y, Huang G, Fu H. Analysis of 17 children with renal abscess. Int J Clin Exp Pathol. 2019;12(9):3179-3184.

Kitaoka H, Inatomi J, Chikai H, et al. Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: a case report. Pediatr. 2020;20(1):461. doi: 10.1186/s12887-020-02366-5

Tamburrini S, Lugarà M, Iannuzzi M, et al. Pyonephrosis ultrasound and computed tomography features: a pictorial review. Diagnostics (Basel). 2021;11(2):331. doi: 10.3390/diagnostics11020331

Meola M, Ibeas J, Lasalle G, Petrucci I. Basics for performing a high-quality color Doppler sonography of the vascular access. J Vasc Access. 2021;22(l):18-31. doi: 10.1177/11297298211018060

Pšeničny E, Glušič M, Pokorn M, Ključevšek D. Contrast-enhanced ultrasound in detection and follow-up of focal renal infections in children. Br J Radiol. 2022;95(1140):20220290. doi: 10.1259/bjr.20220290

Caraiani C, Yi D, Petresc B, Dietrich C. Indications for abdominal imaging: When and what to choose? J Ultrason. 2020;20(80):e43-e54. doi:10.15557/JoU.2020.0008

El-Ghar MA, Farg H, Sharaf DE, El-Diasty T. CT and MRI in Urinary Tract Infections: A Spectrum of Different Imaging Findings. Medicina (Kaunas). 2021;57(1):32. doi: 10.3390/medicina57010032

Szczepańska M, Bałasz-Chmielewska I, Grenda R et al. The Polish Society for Pediatric Nephrology (PTNFD) recommendations on the management of children with nephrotic syndrome. Renal Disease and Transplantation Forum. 2022;15(1):36-57. doi: 10.5603/RDTF.2022.0001

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Published

2024-09-30

How to Cite

Kowalczyk, K., Ożóg, K., Klęba, J., Kucharska-Miąsik, I., Guzik, A., & Guz, W. (2024). The importance of ultrasonography examination in renal abscesses in pediatric patients. European Journal of Clinical and Experimental Medicine, 22(3), 582–588. https://doi.org/10.15584/ejcem.2024.3.18

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ORIGINAL PAPERS