教程nyu cases peds 51儿科病例75.pdfVIP

Case 51 Case directory Craniolacunae (lacunar skull, luckenschadel) ◼ Multiple lacunae: ◼ Physiologic up to 6 months ◼ reased intracranial pressure ◼ Mesenchymal dys sia (lacunar skull, luckenschadel) ◼ Abnormal development (dys sia) of membranous bones of skull ◼ Associated with: myelomeningocele, myelocele, encephalocele ◼ DDX: ◼ Normal convolutional markings seen in the vau uring the period of rapid brain growth (3 to 7 years) Case 52 Primary megaureter ◼ Case findings: ◼ Intravenous urogram: gross dilatation of both distal ureters with more modest dilatation of the more proximal collecting system ◼ Primary megaureter: ◼ Dilatation of the ureter is not related either to VUR or obstruction ◼ May be an abnormality in the nerve plexuses in the ureter reducing peristalsis ◼ Secondary megaureter: ◼ Ureteric dilatation has a cause ◼ MC vesicoureteric junction obstruction, post surgical obstruction, ureteric calculus or tumor, bladder outlet obstruction Case directory Primary megaureter ◼ Isotope renogram: full bladder and modera y dilated ureters bila lly Case 53 Crossed fused renal ectopia ◼ US: two kidneys lying in the left abdomen, with fusion of lower pole of LK to the upper pole of the transposed RK ◼ Two kidneys are on the same side of the body (MC right) ◼ Lower element is ectopic ◼ Ureter from this lower element crosses the midl o enter the bladder in the normal position Crossed fused renal ectopia Case d