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Çocukluk Yaş Grubunda Çift Toplayıcı Sistem

Duplicated Collecting System in a Series of Children

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DOI: 
DOI 10.5262/tndt.2012.1003.04
Abstract (2. Language): 
OBJECTIVE: To report a series of children with duplicated collecting system (DCS) and associated problems. MATERIAL and METHODS: The data of patients with DCS between 1996 and 2011 was reviewed retrospectively. RESULTS: DCS was reported in 59 (M/F:18/41) patients. Mean age at diagnosis was 81.5±41.3 (3- 159) months, mean follow-up duration was 32.2±29.1 (3-130) months. Presenting symptoms were urinary tract infection in 33, nocturnal enuresis in three, diurnal enuresis in two, kidney stones in three and miscellaneous in the rest of the patients. The diagnostic modalities were magnetic resonance urography in three, voiding cystourography in fi ve and intravenous pyelography in the rest. Twentyfour (41%) had right-sided, 24 (41%) had left-sided and 11 (18%) had bilateral DCS in a total of 70 renal units. Insertion of ureters into the bladder could be demonstrated in 33 units (20 incomplete, 13 complete). Vesicoureteral refl ux was found in 16, and ureterocele was found in four renal units. There was refl ux to both moieties in two patients. Surgical interventions included partial nephrectomy in two, ureteroureterostomy in one and anti-refl ux surgery in three of the patients. One patient had Noonan Syndrome and another had atrial septal defect. CONCLUSION: This series was reported to emphasize the clinical and anatomical problems associated with DCS.
Abstract (Original Language): 
AMAÇ: Çocuklarda çift toplayıcı sistem (ÇTS) anomalisi ve ilişkili problemlerin sunulması. GEREÇ ve YÖNTEMLER: 1996-2011 yılları arasında ÇTS anomalisi bulunan hastalara ait veriler geriye dönük olarak değerlendirildi. BULGULAR: ÇTS anomalisi olan 59 (E/K:18/41) hastanın tanı anında ortalama yaşı 81,5±41,3 (3- 159) ay, ortalama izlem süresi ise 32,2±29,1 (3-130) ay idi. Başvuru nedeni 33 hastada idrar yolu enfeksiyonu, üç hastada gece altına işeme, iki hastada gündüz altına kaçırma, üç hastada böbrek taşı ve 18 hastada diğer nedenlere bağlı idi. Hastalardan üçünün manyetik rezonans ürografi , beşinin voiding sistoüretrogram ve diğerlerinin intravenöz piyelografi ile tanı aldığı görüldü. ÇTS anomalisi 24 hastada sağ (%41), 24 hastada sol (%41) ve 11 hastada ise (%18) iki yanlı olmak üzere toplam 70 böbrek biriminde saptanmıştı. Üreterlerin mesaneye giriş özellikleri belirlenebilen 28 hastaya ait 33 böbrek biriminden 13’ünde tam, 20’sinde kısmi duplikasyon anomalisi izlendi. On altı böbrek biriminde mesaneden üretere geri kaçış, dört tanesinde ise üreterosel vardı. Bir hastada hem alt hem üst üretere kaçış, bir hastada ise sağda alt, solda üst üretere kaçış olduğu gözlendi. Hastaların ikisine parsiyel nefrektomi, birine üreteroüreterostomi ve üçüne anti-refl ü cerrahisi uygulandığı görüldü. Bir hastada Noonan Sendromu, bir hastada sekundum tipi atrial septal defekt saptandı. SONUÇ: Bu hasta serisi, çocuklarda ÇTS ile birlikte görülebilecek klinik ve anatomik sorunlara dikkat çekmek amacı ile sunulmuştur.
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