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6 year old diagnosed with moderate pelviectasis in uterus, kidney issues since infant, MRI showed early bifurcation in left kidney. Meaning?

Hello, my daugher who is 6 now was diagnosed with moderate pelvietasis in utero and has had issues with her kidney since she was 2months old. Recently she had a MR urogram and it showed early bifurcation in the left kidney however it did not show a crossing blood vessel which is why the test was ordered, So my question is what is early bifucation and should I be concerned about this? Also if she doesnt have a blockage why is her kidney and collection chamber still dilated?
Asked On : Thu, 23 Aug 2012
Answers:  2 Views:  191
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Pediatrician, Surgery 's  Response
Thank you for your query.
Pelvic dilatation is detected in 1 out of 100 pregnancies. Only 1 out 5 such cases have any significant dilatation after birth. And only half of the ones who have a significant dilatation land up with up surgery. The best way to diagnose whether this dilatation is due to any significant obstruction is by a DTPA scan. It will tell you how much percent the affected kidney is working and whether there is obstruction or not. If the function on the affected side is less than 40% or it is obstructed, the child needs surgery (called pyeloplasty). However if it is not the case, then the child just needs regular follow ups with ultra sounds and DTPA scans. If it worsens the child may still require pyeloplasty. However many children outgrow this dilatation and there is nothing to worry about. Further more abnormal crossing vessel is rare in children and commoner in adults. Mild bifurcation of the pelvis needs no surgery unless there is obstruction. So you can be assured in that regards. And please specify what kinds of problems the child is actually facing. If it is just the ultrasound reports you are worried about then just be reassured. But if the child is having symptoms related to this dilatation then the child will need surgery irrespective of the other reports.
Show your child to a pediatric surgeon for further guidance
Hope this helps.
Answered: Sun, 23 Dec 2012
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