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Inflamed Urachal Remnant
Joseph Junewick, MD FACR
over 6 years ago
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Renal Ischemia

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Premature infant with necrotizing enterocolitis and anuria.


Case Images


Diagnosis

Renal Ischemia

Findings

US – Sagittal images of the right and left kidneys show lamellated hyperechogenicity of the cortex and asymmetric corticomedullary differentiation. Both kidneys were enlarged based on weight normative data.

Discussion

The etiology of renal insufficiency in neonates is most often related to renal hypoperfusion. Perinatal asphyxia, sepsis, surfactant deficiency, and congenital heart disease (including patent ductus arteriosum) can result in prerenal dysfunction. Medicines contributing to neonatal renal insufficiency include prostaglandins inhibitors, tolazoline (used to treat pulmonary hypertension), neuromuscular agents used in neonates on ventilators, and antibiotics (amphotericin B). Positive pressure ventilation and umbilical artery catheters may decrease renal perfusion. Sonographic findings vary with the phase of the injury/recovery; early on renal size is increased, echogenicity is disordered and diastolic flow is decreased.

Reference

Mercado-Deane M, Beeson JE, John SD. US of renal insufficiency in neonates. Radiographics (2002); 22:1429-1438.

Contributor

Linda Woolpert, RT RDMS



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