Pediatric Radiology

, Volume 42, Issue 9, pp 1107–1111 | Cite as

Utilizing ultrasonography in the diagnosis of pediatric fibroepithelial polyps causing ureteropelvic junction obstruction

Original Article

Abstract

Background

Fibroepithelial polyps are a rare cause of ureteropelvic junction (UPJ) obstruction in children. Preoperative US diagnosis of fibroepithelial polyps is infrequently reported, with intravenous pylogram and retrograde pyelography being most commonly used for diagnosis.

Objective

To recommend the most accurate process for diagnosing this disease in children by assessing a modified ultrasonographic procedure for the diagnosis of fibroepithelial polyps.

Materials and methods

A retrospective review of US and IVP imaging studies performed in surgically and histologically confirmed cases of fibroepithelial polyps in children. Each child was asked to drink as much water as possible 30 min before the US testing. For US, the renal pelvis, UPJ and the proximal ureter were inspected for an echogenic mass resulting in hydronephrosis. For IVP studies, abdominal plain films were performed at 7, 15 and 30 min following contrast injection.

Results

Thirty-five children, 34 boys and 1 girl, had confirmed fibroepithelial polyps. The children ranged in age from 3 to 14 years (mean age 9 years). Clinical presentation included intermittent vague abdominal pain (100%) and/or hematuria (9.7%) for a period ranging from 1 month to 5 years. Of the 35 children (37 polyps), 21 (23 polyps) were correctly diagnosed preoperatively with US, establishing a 62.2% (23/37) US accuracy rate. Twenty polyps were seen on the left, three on the right and two children had bilateral polyps. The masses were all mildly echogenic with defined edges. Eight children (9 polyps) had an IVP consistent with fibroepithelial polyps giving IVP an accuracy rate of 24.3% (9/37).

Conclusion

US is an effective screening tool for identifying fibroepithelial polyps causing UPJ obstruction in children.

Keywords

Fibroepithelial polyp Ureteropelvic junction obstruction Ultrasonography Pediatric 

References

  1. 1.
    Cassar DE, Joseph VT, Scherwood W (2007) Fibroepithelial polyps causing ureteropelvic junction obstruction in children—a case report and review article. Eur J Pediatr Surg 17:142–146CrossRefGoogle Scholar
  2. 2.
    Klahr S (1983) Pathophysiology of obstructive nephropathy. Kidney Int 23:414–426PubMedCrossRefGoogle Scholar
  3. 3.
    Shoichiro I, Yoshiyuki K, Kentaro M (2010) Laparoscopic management of fibroepithelial polyp causing ureteropelvic junction obstruction in a child. J Urol 76:146–148CrossRefGoogle Scholar
  4. 4.
    Gregorys A, Sarao V, Alanb R (2003) Fibroepithelial polyps causing ureteropelvic junction obstruction in children. J Urol 169:1834–1836CrossRefGoogle Scholar
  5. 5.
    Li WM, Wu WJ, Ke HL (2005) Fibroepithelial polyps causing ureteropelvic junction obstruction in a child. Kaohsiung J Med Sci 21:282–284PubMedCrossRefGoogle Scholar
  6. 6.
    Chen WF, Huang SC, Yu TJ (1994) Benign ureteral polyp as a cause of obstruction in a child. Pediatr Surg Int 9:436–437CrossRefGoogle Scholar
  7. 7.
    Kim KK, Lee JH, Cho CH (1997) Ureteral fibroepithelial polyp associated with ureteropelvic junction obstruction in a child. JKMS 12:477–479Google Scholar
  8. 8.
    Romesburg JW, Stein RJ, Desai MM (2009) Treatment of a child with bilateral ureteropelvic junction obstruction due to fibroepithelial polyps and review of the literature. J Urology 73:929.e9–929.e11CrossRefGoogle Scholar
  9. 9.
    Kojima Y, Lambert SM, Steixner BL (2011) Multiple metachronous fibroepithelial polyps in children. J Urol 185:1053–1057PubMedCrossRefGoogle Scholar
  10. 10.
    Bhalla RS, Schulsinger DA, Wasnick RJ (2002) Case report: treatment of bilateral fibroepithelial polyps in a child. J Endourol 16:581–582PubMedCrossRefGoogle Scholar
  11. 11.
    Niu ZB, Yang Y, Hou Y (2007) Ureteral polyps: an etiological factor of hydronephrosis in children that should not be ignored. Pediatr Surg Int 23:323–326PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Xiao Man Wang
    • 1
  • Li Qun Jia
    • 1
  • Yu Wang
    • 1
  • Ning Wang
    • 1
  1. 1.National Key Discipline of Pediatrics, Capital Medical University, Ministry of Education, Department of UltrasoundBeijing Children’s HospitalBeijingChina

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