A 2 year old boy presented with a hard mass in the left hemisphere scrotum. The mass had been noticed by his parents almost 3 months ago, and appeared to be progressively increasing in size.
A 4 year old boy with persistent foul smelling umbilical discharge was brought in to see me for a further opinion. He had been to several GPs and Paediatricians over the last 3.5 years, and had received conservative treatment and reassurance.
A 4 year old Indonesian girl, who 2 years ago had undergone surgery to resect a left sided Wilms’ Tumour re- presented with a left sided abdominal mass.
A CT scan revealed a large tumour in front of the left kidney with the left kidney being normal in its shape and morphology.
A 2.5 year old boy from Indonesia presented with a large intra abdominal mass. Clinically it appeared to arise from his right kidney. A CT scan confirmed this.
A 4 year old girl, previously diagnosed to have gross hydronephrosis of her right kidney (Diagnosed in Singapore) , came to seek further treatment with me following two episodes of right sided flank pain. Ultrasound strongly suggested features of a PUJ obstruction of her right kidney and a MAG3 Nuclear Medicine Scan confirmed a very delayed washout of the tracer across the PUJ with a right renal function of 35%. She underwent a successful Laparoscopic Pyeloplasty over a DJ stent and has since even had the DJ stent removed and is doing very well.
DJ STENT INSERTION DURING THE PROCEDURE
A 1 year old Girl from Indonesia was brought by her mother for further management of recurrent UTI. The child had had her first UTI at the age of 3 months. Investigations in Indonesia revealed that the child had a Duplex Right kidney with what appeared to be Hydronephrosis of the right upper Moiety. Further detailed investigations revealed that the Right Upper Moiety Ureter was also dilated and there was a large Ureterocoele in the bladder. A MAG3 revealed 10% function of the upper moiety. I decided to puncture the ureterocoele and allow drainage of the obstructed right upper moiety and treat the child conservatively to see if the hydronephrosis improves . Follow up scans revealed a decrease in hydronephrosis and a decompression of the ureterocoele.
2 years 6 month old Indian Girl with recurrent UTI from the age of 1 year. Referred to me by a Paediatrician from a neighbouring state. Investigations revealed that the child had Bilateral Duplex Kidneys. On the left there was a very hydronephrotic Upper Moeity with its grossly dilated ureter and a large ureterocoele in the bladder. There was no discernible function in the left upper Moiety . Hence a Laparoscopic Left Upper Hemi-nephroureterectomy was performed. The child recovered extremely well.
A 3 year old Indonesian boy presented with an abdominal mass that the parents had noticed a year ago. He was initially seen by a paediatric Surgeon at another private centre and referred to an adult Urologist who did certain imaging studies. The parents however chose to seek a second opinion with me.
Physical examination revealed a 3 year old who weighed only 8.9 kgs who was otherwise pink, active and well. The cause of his abdominal mass was an enlarged left kidney.