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Urinary and Genital Disorders (Children)

Enlarged kidney

12/22/2008

Question:

My 7yr old daughter has been suffering with servere pain for 5yrs now, to the point where the pain is so bad that all she can do is scream, lay with her legs curled up with a heat pack & vomit. We are having no luck with pain relief. She has had Mag 3 renal scan, DTPA each saying that Left kidney larger than right, Hydronephrosis on left side, thinning of the cortex of the left kidney, single cyst bilateraly no evident scarring. She is not getting any better she is having pain constantly levels of pain change. Please, she just wants one wish & that is this pain & sicknes to STOP so she can be a normal 7yr old. Thanks!!!

Answer:

It sounds like she could have an obstructed left kidney, but I assume that condition would have been repaired in the past. If the drainage is slow from the left kidney on the MAG-3, then that would be a sign of a potentially correctable problem. However, other possibilities may exist also. I assume that she has been seeing a pediatric gastroenterologist, because gastrointestinal disorders also can cause severe abdominal pain with vomiting. Review of her condition and radiologic studies with a pediatric urologist would be prudent. Sometimes an MR urogram provides more information than a MAG-3 kidney scan on the specific anatomy, and may show the cause for her pain. Good luck.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University