Evaluation of Differential Renal Function and Renographic Patterns in Patients with Dietl Crisis

Sparks, Scott; Viteri, Bernarda; Sprague, Bruce M.; Rushton, H. Gil; Pohl, Hans G.; Majd, Massoud

doi:10.1016/j.juro.2012.09.051

Cited by 10 publications

(3 citation statements)

References 5 publications

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“…Baseline DRF in patients with symptomatic hydronephrosis is typically well-preserved. In a study conducted by Scott Sparks et al, 28.81% of patients had preoperative DRF less than 40% [5], while in Chen et al's study, it was 30.77% [4]. In our study, 28.4% of patients had baseline DRF less than 40%.…”

Section: Discussioncontrasting

confidence: 47%

Risk Factors Analysis for Baseline Renal Function Impairment in Patients with Ureteropelvic Junction Obstruction and Intermittent Abdominal Pain

et al. 2023

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Objective This study aimed to investigate whether ultrasound parameters during non-painful episodes could indicate impaired differential renal function (DRF) in patients with ureteropelvic junction obstruction (UPJO) and intermittent abdominal pain. Methods We conducted a retrospective review of all cases of unilateral UPJO with intermittent abdominal pain undergoing their first pyeloplasty between March 2019 and October 2021. Clinical characteristics, such as gender, affected side, age at the first onset of pain, waiting time for pyeloplasty, age, and concurrent symptoms, were collected. Ultrasound examination (US) was used to measure the anteroposterior diameter (APD) and renal parenchyma thickness (PT) during intermittent pain episodes and dynamic renal scintigraphy (RDS) was used to assess DRF. Results This study investigated the characteristics and demographics of 109 patients with UPJO. Of the patients, 28.4% had baseline DRF less than 40%, and factors affecting baseline DRF were analyzed. Patients diagnosed with hydronephrosis before the onset of pain had a lower risk of DRF impairment compared to those diagnosed after the onset of pain (p = 0.021). Patients with impaired renal function had larger APD and thinner PT values on ultrasound (p = 0.002, p༜0.001). Abdominal pain accompanying symptoms were found to be associated with DRF impairment (p = 0.044). Multifactorial analysis identified that right UPJO, diagnosis of UPJO after pain onset, large APD, and thin PT were risk factors for baseline DRF damage in patients with intermittent abdominal pain (p༜0.05). Conclusion Patients with right-sided UPJO, UPJO diagnosed after a pain episode, and those with larger APD and thinner PT on ultrasound during pain-free intervals were more likely to have DRF impairment.

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Section: Discussioncontrasting

confidence: 47%

Risk Factors Analysis for Baseline Renal Function Impairment in Patients with Ureteropelvic Junction Obstruction and Intermittent Abdominal Pain

et al. 2023

Preprint

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“… Older children with recurrent abdominal pain and HN to diagnose intermittent UPJ obstruction as the cause of the symptoms. Diuresis renography in these patients would be most informative if it is done during or within 24 h after an episode of pain ( 3 ). Evaluation of renal function and postdiuresis drainage after surgical interventions.…”

Section: Common Clinical Indicationsmentioning

confidence: 99%

The SNMMI and EANM Procedural Guidelines for Diuresis Renography in Infants and Children

et al. 2018

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“…More recently, laparoscopic pyeloplasty (with or without robotic assistance) has emerged as an adequate surgical intervention that causes complete resolution of symptoms in most cases [3] . While congenital UPJ obstruction is usually identified on routine prenatal ultrasound (US), some children present at an older age with episodes of abdominal or flank pain on the side of the obstruction, that may be associated with nausea and/or nonbilious vomiting, prompting multiple emergency department (ED) visits [4] . In view of complete symptom resolution with corrective surgery, accurate and prompt identification of patients with Dietl crisis with imaging tests becomes crucial.…”

Section: Introductionmentioning

confidence: 99%

Dietl crisis: Presentation and imaging findings in a 7-year-old boy

Lahoud

Esker

Thurston

et al. 2021

Radiology Case Reports

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Intermittent ureteropelvic junction obstruction, or Dietl crisis, is a rare entity with sparse reports in published literature. Establishing the diagnosis is challenging given its intermittent nature. We report a case of Dietl crisis, focusing on ultrasound (US) and magnetic resonance urography (MRU) findings in a 7-year-old boy with recurrent episodes of colicky abdominal pain prompting multiple visits to the emergency department. Severe left hydronephrosis was visualized on US during one episode with complete resolution on follow-up US. MRU demonstrated severe left hydronephrosis with delayed calyceal transit time, time-to-peak enhancement, and excretion. There was no aberrant blood vessel. Surgical pyeloplasty provided complete symptomatic resolution. MRU can be a valuable tool in eliciting and dynamically confirming the diagnosis of Dietl crisis.

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Evaluation of Differential Renal Function and Renographic Patterns in Patients with Dietl Crisis

Cited by 10 publications

References 5 publications

Risk Factors Analysis for Baseline Renal Function Impairment in Patients with Ureteropelvic Junction Obstruction and Intermittent Abdominal Pain

Risk Factors Analysis for Baseline Renal Function Impairment in Patients with Ureteropelvic Junction Obstruction and Intermittent Abdominal Pain

The SNMMI and EANM Procedural Guidelines for Diuresis Renography in Infants and Children

Dietl crisis: Presentation and imaging findings in a 7-year-old boy

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