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Child with mild enlargement in right kidney, mild increase in renal parenchyma echogenicity, no evidence of pelvicaliectasis . Suggestion?

Sir, Age-8year old, sex-male. there is mild enlargement in the right kidney(9.30cm).left kidney is small in size (5.90cms)there is mild increase in the renal parenchymal echogenicity.the renal parenchyma shows punctuate ,echogenecities- vascular ? microcysts? cortico-medullary differentiation is not well evidence of pelvicaliectasis or calculus . could u please explain what is the conditon and is there any serious complications in future
Asked On : Mon, 4 Mar 2013
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Pediatrician, Surgery 's  Response
Thank you for your query on Heath-Care-Magic
First thing that we need to know is what symptoms does the child have? The above conditions can be due to various reasons. Multiple cysts in the kidney can be
1. Polycystic kidney disease. I am not writing the description because although the ultrasound finds matches its diagnosis, it is always on both sides and never on one kidney
2. Multicystic dysplatic kidney: It is a congenital (by birth) disease in which the kidney has has not developed normally and instead is just a collection of multiple cysts. These kidneys do not function but usually get absorbed by this age. If it is s then you should get his kidney removed else it can cause elevated blood pressure.
3. Dysplastic kidney: Sometimes the urine from the bladder abnormally goes back in to kidneys. It can cause damage to the kidneys and resultant dysplasia
4. Tumor: A cancer of the kidney (Wilms' tumor) can also present as solid mass with multiple cysts
But it comonly happens under 5 years
5. Infected kidney (Xanthogranulomatous pyelonephritis): A kidney with repeated infection can turn like this
That is why detailed history is important as none of these conditions can be ignored and we may need a few tests to confirm these things like a CT scan, may be biopsy, a functional study of the kidney (renal dynamic scan or DTPA scan) and blood tests. You should consult a pediatric surgeon as soon as possible
Hope the information answers your query
God bless you
Answered: Sun, 10 Mar 2013
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