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Kidney Injury
Children can sustain injury to kidney when there is blow
to the loin either during a road traffic accident or a
handle bar injury during cycling. The damage to the
kidney can very from mild to serious type. There may be
pain, blood in urine etc. CT scan is often required to
confirm the extent of damage. Often the treatment is bed
rest. Surgery is required only if there is continuous
blood loss.
Urethral Injury
When boys fall on to a branch of a tree while climbing,
or on cycle bar during cycling, the urethra located in
between the legs is injured. When there is severe injury
there will be blood from the tip of the penis and the
child might not be able to pass urine; with urine
accumulating in the bladder. A temporary diversion of
urine directly from the belly may be required.
Pyonephrosis
This term refers to pus in the kidney. This can be a
result of obstruction to the urine flow and infection
developing in it. It is a very serious problem requiring
admission, IV fluids and IV antibiotics. In addition
prompt relief of pressure has to be done to prevent
complete loss of function in that kidney. The conditions
that can lead to this include
Blockage at the upper end of ureter (PUJ obstruction)
Blockage at the lower end of ureter (VUJ obstruction)
Renal failure
If both kidneys are blocked then it can rapidly lead to
renal failure. There can be very low to absent urine
output (anuria). The conditions that can lead to this
serious problem, even in the newborn period, include
Posterior Urethral Valves
Ureterocele blocking bladder outlet
They need to be carefully treated by experts in the
field. Some times a simple catheter can revert the
situation. Dialysis may be required before planning
definitive surgery. Both of these problems can be
tackled by a simple endoscopic surgery, relieving the
blockage.
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