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Urinary and Genital Disorders (Children)

Enlarged kidneys on abdominal ultrasound

09/21/2006

Question:

My 8 yr. old son has had an ongoing problem for the past four years of sudden onset of pain on his middle right side followed by vomiting. He has an episode about every 4-6 weeks with a lot of pain which lasts anywhere from 1-4 hours and is usually relieved after he throws up. They have run tests in the past, abdominal CT, upper GI, blood work and urine which did not reveal anything. Just recently after we took him back in looking for answers they found that on the ultrasound both of his kidneys are enlarged. We have an appointment with a pediatric urologist but it is not for a couple of weeks. I just want to know what what might be causing this. He has never had a UTI or complained of any pain during urination, but he is thirsty a lot and does have to go to the restroom quite often.

Answer:

Occasionally, children may have what is known as intermittent obstruction of the kidneys due to "UPJ" obstruction. This is a condition where there is a kink in the tubes bringing the urine from the kidneys to the bladder. The tubes can become intermittently obstructed leading to symptoms similar to kidney stones.

The history is the most important aspect of the evaluation and if the diagnosis is confirmed, surgery can cure the problem forever. Alternatively, there is a condition called cyclic vomiting syndrome which is poorly understood but can sometimes be managed with medications.

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Response by:

Rama   Jayanthi, MD Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University