Surgical management of urinary stones in children remains challenging due to the smaller caliber of the urinary tract. Specific instruments have been designed to overcome some of the issues related to pediatric stone management. Endoscopic and percutaneous modalities for stone management have been shown to be as safe and effective in providing stone clearance in children as in adults. Technologies that have been shown to be safe in adults are being miniaturized for use in children. The current literature regarding pediatric urolithiasis was reviewed in an effort to identify trends in operative management. Additionally, techniques used successfully at our institution are described. Although not an exhaustive review of all available modalities and instruments, this review will provide an overview of the current techniques for the management of pediatric urolithiasis.
Injection of dextranomer/hyaluronic acid copolymer (DefluxTM or Dx/HA) has become a common urologic procedure for treatment of low to intermediate grade vesicoureteral reflux. We report a rare case of a child with history of DefluxTM injection presenting to our emergency department with abdominal pain and non-contrast CT findings of a distal ureteral calcification mimicking a ureteral stone. Emergency physicians and consulting urologists need to be aware of this phenomenon and consider calcified Deflux as a potential differential diagnosis when evaluating young adults with abdominal pain and CT findings suggestive of distal ureteral calcification.
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