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Agarwal A, Goyal J, Nayak A. Prune belly syndrome. Indian Dermatol Online J 2022; 13:442-443. [PMID: 36225999 PMCID: PMC9549532 DOI: 10.4103/idoj.idoj_656_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 11/04/2022] Open
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Keet K, Henry BM, Tubbs RS. Prune-belly syndrome in Africa: An analysis and systematic review of cases, etiology, treatment, and outcomes. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/2051415820903196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Prune-belly syndrome is a rare congenital disorder characterized by a spectrum of three anomalies: bilateral undescended testes, dilated urinary tract, and anterior abdominal muscle deficiency. Objectives: In developing countries, inadequate access to health care may affect treatment and outcomes of prune-belly syndrome. This study’s goal was to review the anatomical features, etiology, genetics, management, and outcomes of cases in Africa. Methods: PubMed was searched to identify case reports and case studies describing prune-belly syndrome in Africa. Data collected from each study included the number of cases, age at diagnosis, sex, description of the abdominal muscles, testes, and urinary tract, as well as associated anomalies, management, and long-term outcomes. Results: A total of 16 publications that reported 58 cases in African countries were included. The prevalence of female patients (15.5%) was higher than in developed countries (3%). The abdominal muscles were deficient in all cases, and bilateral cryptorchidism was present in nearly all males (96%). Distension of the bladder was common, with normal anatomy reported in only one case. Bilateral hydroureters and hydronephrosis also were present in the majority of cases. Only six cases (10.3%) had no associated anomalies, such as musculoskeletal or cardiovascular. Karyotyping was performed in only three cases (5.2%) because of limited hospital facilities. Six parents (10.3%) declined treatment for their children, 12 cases (20.7%) were managed conservatively, and 25 (43.1%) received surgical intervention. Patients’ mortality rate was higher than in developed countries. Conclusion: Diagnosis and treatment of prune-belly syndrome remains a challenge in Africa, in which multiple factors, such as access to health care and cultural beliefs, affect mortality rates and outcomes. Patient education and support groups may improve compliance with treatment. Level of evidence: Not applicable for this multicenter audit.
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Affiliation(s)
- Kerri Keet
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Brandon Michael Henry
- Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children’s Hospital Medical Center, USA
| | - R Shane Tubbs
- Departments of Neurosurgery and Structural and Cellular Biology, Tulane University School of Medicine, USA
- Department of Anatomical Sciences, St. George’s University, Grenada
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Prune Belly Syndrome in the Pig (Sus scrofa domesticus). J Comp Pathol 2019; 174:81-85. [PMID: 31955808 DOI: 10.1016/j.jcpa.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 11/22/2022]
Abstract
Prune belly syndrome (PBS) is a rare multisystemic disease characterized by a deficiency of abdominal wall musculature, urinary tract anomalies and bilateral intra-abdominal testes. PBS in females is called pseudo prune belly syndrome (PPBS) and is characterized by abdominal wall laxity and urinary tract defects. We report three male and one female stillborn piglets with abdominal distension, hypoplastic abdominal wall musculature and urinary tract anomalies. Bilateral cryptorchidism was observed in the males. In addition, two males showed anomalous liver lobulation, one of them had an anomalous spleen and the other an atrial septal defect. As far as we know, neither PBS nor PPBS have been reported in veterinary literature until now.
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Arlen AM, Nawaf C, Kirsch AJ. Prune belly syndrome: current perspectives. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2019; 10:75-81. [PMID: 31496864 PMCID: PMC6689549 DOI: 10.2147/phmt.s188014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/13/2019] [Indexed: 11/23/2022]
Abstract
Prune belly syndrome (PBS) is a rare but morbid congenital disease, classically defined by a triad of cardinal features that includes cryptorchidism, urinary tract dilation and laxity of the abdominal wall musculature. Children often require numerous surgical interventions including bilateral orchidopexy as well as individually tailored urinary tract and abdominal wall reconstruction. Along with the classic features, patients with PBS often experience gastrointestinal, orthopedic, and cardiopulmonary comorbidities.
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Affiliation(s)
- Angela M Arlen
- Yale University School of Medicine, Department of Urology, New Haven, CT 06520, USA
| | - Cayce Nawaf
- Yale University School of Medicine, Department of Urology, New Haven, CT 06520, USA
| | - Andrew J Kirsch
- Emory University, Children's Healthcare of Atlanta, Atlanta, GA 30328, USA
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5
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White JT, Sheth KR, Bilgutay AN, Roth DR, Austin PF, Gonzales ET, Janzen NK, Tu DD, Mittal AG, Koh CJ, Ryan SL, Jorgez C, Seth A. Vesicoamniotic Shunting Improves Outcomes in a Subset of Prune Belly Syndrome Patients at a Single Tertiary Center. Front Pediatr 2018; 6:180. [PMID: 30018947 PMCID: PMC6038357 DOI: 10.3389/fped.2018.00180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 06/01/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Review outcomes of Prune Belly Syndrome (PBS) with the hypothesis that contemporary management improves mortality. Methods: A retrospective chart review of inpatient and outpatient PBS patients referred between 2000 and 2018 was conducted to assess outcomes at our institution. Data collected included age at diagnosis, concomitant medical conditions, imaging, operative management, length of follow-up, and renal function. Results: Forty-five PBS patients presented during these 18 years. Prenatal diagnoses were made in 17 (39%); 65% of these patients underwent prenatal intervention. The remaining patients were diagnosed in the infant period (20, 44%) or after 1 year of age (8, 18%). Twelve patients died from cardiopulmonary complications in the neonatal period; the neonatal mortality rate was 27%. The mean follow-up among patients surviving the neonatal period was 84 months. Forty-two patients had at least one renal ultrasound (RUS); of the 30 patients with NICU RUSs, 26 (89%) had hydronephrosis and/or ureterectasis. Of the 39 patients who underwent voiding cystourethrogram (VCUG), 28 (62%) demonstrated VUR. Fifty-nine percent had respiratory distress. Nine patients (20%) were oxygen-dependent by completion of follow up. Thirty-eight patients (84%) had other congenital malformations including genitourinary (GU) 67%, gastrointestinal (GI) 52%, and cardiac 48%. Sixteen patients (36%) had chronic kidney disease (CKD) of at least stage 3; three patients (7%) had received renal transplants. Eighty-four percent of patients had at least one surgery (mean 3.4, range 0-6). The most common was orchiopexy (71%). The next most common surgeries were vesicostomy (39%), ureteral reimplants (32%), abdominoplasty (29%), nephrectomy (25%), and appendicovesicostomy (21%). After stratifying patients according to Woodard classification, a trend for 12% improvement in mortality after VAS was noted in the Woodard Classification 1 cohort. Conclusions: PBS patients frequently have multiple congenital anomalies. Pulmonary complications are prevalent in the neonate while CKD (36%) is prevalent during late childhood. The risk of CKD increased significantly with the presence of other congenital anomalies in our cohort. Mortality in childhood is most common in infancy and may be as low as 27%. Contemporary management of PBS, including prenatal interventions, reduced the neonatal mortality rate in a subset of our cohort.
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Affiliation(s)
- Jeffrey T White
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Kunj R Sheth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Aylin N Bilgutay
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - David R Roth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Paul F Austin
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Edmond T Gonzales
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Nicolette K Janzen
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Duong D Tu
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Angela G Mittal
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Chester J Koh
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Sheila L Ryan
- Memorial Hermann Health System, Houston, TX, United States
| | - Carolina Jorgez
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States
| | - Abhishek Seth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
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Satar M, Özlü F, Yapıcıoğlu H, İskit S. Corset Usage for Gastrointestinal and Respiratory Problems in a Newborn with Prune Belly Syndrome. Indian J Pediatr 2016; 83:717-9. [PMID: 26729223 DOI: 10.1007/s12098-015-1975-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 11/27/2015] [Indexed: 11/27/2022]
Abstract
Prune Belly syndrome (PBS), comprises a triad of anomalies that include abdominal wall flaccidity, urologic anomalies and bilateral cryptorchidism in males. The abdominal musculature hypoplasia predisposes to respiratory problems, respiratory infections secondary to impaired cough mechanism, and cause chronic constipation secondary to ineffective valsalva ability. Here, the authors present a newborn baby with Prune Belly syndrome who had respiratory and gastrointestinal problems which resolved after corset use. To the authors knowledge, this is the first case of corset usage in the treatment of PBS in a newborn infant.
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Affiliation(s)
- Mehmet Satar
- Department of Neonatology, Faculty of Medicine, Çukurova University, 01330, Adana, Turkey.
| | - Ferda Özlü
- Department of Neonatology, Faculty of Medicine, Çukurova University, 01330, Adana, Turkey
| | - Hacer Yapıcıoğlu
- Department of Neonatology, Faculty of Medicine, Çukurova University, 01330, Adana, Turkey
| | - Serdar İskit
- Department of Pediatric Surgery, Faculty of Medicine, Çukurova University, Adana, Turkey
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7
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Brodsky MC, Turan KE, Khanna CL, Patton A, Kirmani S. Congenital mydriasis and prune belly syndrome in a child with an ACTA2 mutation. J AAPOS 2014; 18:393-5. [PMID: 24998021 DOI: 10.1016/j.jaapos.2014.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 12/14/2022]
Abstract
We report the association of congenital mydriasis with prune belly syndrome and cerebrovascular anomalies in a 9-year-old boy who was found to have an ACTA2 mutation. This case illustrates the spectrum of systemic malformations that are attributable to mutations in ACTA2 and expands the spectrum of cerebrovascular anomalies that are now known to accompany congenital mydriasis.
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Affiliation(s)
| | - Kadriye Erkan Turan
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Cheryl L Khanna
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Alice Patton
- Department of Medical Genetics Radiology, Mayo Clinic, Rochester, Minnesota
| | - Salman Kirmani
- Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota
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Vasconcelos MAPS, de Lima PP. Prune-belly syndrome: an autopsy case report. AUTOPSY AND CASE REPORTS 2014; 4:35-41. [PMID: 28573127 PMCID: PMC5443131 DOI: 10.4322/acr.2014.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/03/2014] [Indexed: 11/23/2022] Open
Abstract
Prune-belly syndrome (PBS) is a rare congenital anomaly characterized by a spectrum of mild-to-severe presentations of urinary tract malformations, deficient abdominal wall musculature, and cryptorchidism in male newborns or genital abnormalities in the female newborns. Currently, antenatal diagnosis is feasible with ultrasound examination, and treatment is based on case report experience. More recently, intrauterine management has been undertaken with encouraging results. The authors report a case of PBS diagnosed at the seventeenth gestation week, when ultrasonographic examination revealed the presence of ascites, distended bladder, thickened bladder wall and posterior urethral valve. The fetus was submitted to an intrauterine intervention at the nineteenth gestational week. Delivery occurred at 34 weeks of gestation and the newborn examination was consistent with PBS. On the second day of life, the newborn was submitted to abdominoplasty, colostomy, and orchiopexy. However, the outcome was unfavorable with respiratory failure and death on the fifteenth day of life. The autopsy confirmed the diagnosis of PBS, but the immediate cause of death was attributed to aspiration pneumonia.
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Affiliation(s)
| | - Patricia Picciarelli de Lima
- Department of Pathology - Hospital das Clínicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
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Basso MD, Favretto CO, Cunha RF. The association between prune belly syndrome and dental anomalies: a case report. BMC Oral Health 2012; 12:56. [PMID: 23249412 PMCID: PMC3564721 DOI: 10.1186/1472-6831-12-56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 12/17/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. CASE PRESENTATION The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. CONCLUSION This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.
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Affiliation(s)
- Maria Daniela Basso
- Disciplina de Odontopediatria e Clínica Integrada Infantil, UNIOESTE – Univ. Estadual do Oeste do Paraná, Jardim Universitário, Rua Universitária 2069, Cascavel, PR (85819-110), Brazil
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Zugor V, Schott GE, Labanaris AP. The Prune Belly syndrome: urological aspects and long-term outcomes of a rare disease. Pediatr Rep 2012; 4:e20. [PMID: 22802998 PMCID: PMC3395978 DOI: 10.4081/pr.2012.e20] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 11/17/2011] [Accepted: 11/18/2011] [Indexed: 11/23/2022] Open
Abstract
Prune-Belly syndrome is a disorder characterized by the following triad of symptoms: deficiency of the abdominal muscles, malformations of the urinary tract and bilateral cryptorchidism. This study included a total of 16 patients. The findings included clinical characteristics, diagnostics, therapy and long-term clinical outcomes. All patients were asked to complete a questionnaire and, in some cases, were given further examination. All patients were diagnosed with congenital aplasia of the abdominal wall and a variety of urogenital malformations. Cryptorchidism was present in 11 patients (68.8%), malformations of the prostate in 3 (18.8%), urethral malformations in 8 (50%) and mega-ureter in 14 patients (87.5%). A mega-bladder was observed in 13 patients (81.3%). Distinctive renal malformations, such as renal dysplasia, in 3 patients (18.8%) and hydronephrosis in 9 patients (56.3%), respectively. Abdominoplasty was performed on 4 patients (25%). Urethral surgery was performed in 10 patients (62.5%). Seven patients (43.8%) required ureter surgery, most of which involved re-implantation of the ureter and, in some cases, additional ureter modeling. Renal surgery was performed on 5 patients. Four patients with non-functioning kidneys with hydronephrosis underwent a nephrectomy and one patient pyeloplasty. We demonstrate that successful treatment is possible even in cases of serious and complex malformations, such as those of the Prune-Belly syndrome. Treatment must be tailored to the individual patient. The severity of the renal dysplasia is the main prognostic factor.
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Affiliation(s)
- Vahudin Zugor
- Department of Urology and Pediatric Urology-Prostate Center Northwest, St. Antonius Medical Center, Gronau
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Younous S, Zarrouki Y, Boutbaoucht M, Mouaffak Y, El Idrissi KE, Aboussair N, Saiad MO. Prune Belly Syndrome Associated with Full Spectrum of VACTERL in a New Born. J Clin Neonatol 2012; 1:49-51. [PMID: 24027688 PMCID: PMC3761994 DOI: 10.4103/2249-4847.92234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Prune belly syndrome (PBS) is a rare congenital anomaly of uncertain etiology. Many associations of PBS with other malformations were previously reported, but only few cases of the association with VACTERL have been described. We report a rare case of a Moroccan new born with PBS and complete VACTERL association. The cause of this association is still unknown, but a common etiology is possible, especially when for the two syndromes, a defect in mesodermal differentiation, in early first trimester, has been suggested.
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Affiliation(s)
- Said Younous
- Department of Anesthesia & Critical Care, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
| | - Youssef Zarrouki
- Department of Anesthesia & Critical Care, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
| | - Mustapha Boutbaoucht
- Department of Anesthesia & Critical Care, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
| | - Youssef Mouaffak
- Department of Anesthesia & Critical Care, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
| | - Kawtar Ennour El Idrissi
- Department of Anesthesia & Critical Care, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
| | - Nissrine Aboussair
- Department of Genetics, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
| | - Mohammed O Saiad
- Department of Pediatric Surgery, Mother and Child Hospital, Mohammed VI University Hospital of Marrakech, Morocco
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Epelman M, Victoria T, Meyers KE, Chauvin N, Servaes S, Darge K. Postnatal imaging of neonates with prenatally diagnosed genitourinary abnormalities: a practical approach. Pediatr Radiol 2012; 42 Suppl 1:S124-41. [PMID: 22395725 DOI: 10.1007/s00247-011-2177-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 04/07/2011] [Indexed: 12/30/2022]
Abstract
The advent of prenatal US and, more recently, fetal MRI has changed our pattern of referrals. In the current clinical algorithms, most neonates evaluated for genitourinary abnormalities are asymptomatic. These infants are referred for multidisciplinary consultation, imaging and surveillance. Evaluation of these children commences following pertinent review of available prenatal studies; this is appropriate, as in certain instances prenatally gathered information of potential prognostic significance can be inferred or can obviate the need for multiple examinations. US remains the first-line imaging modality for diagnosing urinary abnormalities in neonates and young infants, although it offers primarily morphological assessment. However, US coupled with MAG-3 scanning results in a powerful combination that provides anatomical and functional information. Recently, MRI and MR urography have been increasingly regarded as one-stop-shop examinations that can deliver both anatomical and functional information, and play an increasing role in the evaluation of ureteral ectopia and genital anomalies. Fluoroscopic examinations are reserved to exclude vesicoureteral reflux, to delineate urethral obstruction or to provide additional information to support a diagnosis. A practical approach to postnatal imaging of the neonate is discussed and the important genitourinary anomalies in this age group are presented and illustrated.
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Affiliation(s)
- Monica Epelman
- Department of Radiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
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García Luzardo MR, Valenciano Fuente B, Bas Suárez P, Bello Naranjo AM. [Pseudo-Prune-Belly syndrome: a Prune-Belly without cryptorchidism]. An Pediatr (Barc) 2011; 75:70-2. [PMID: 21439922 DOI: 10.1016/j.anpedi.2010.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Revised: 11/29/2010] [Accepted: 11/30/2010] [Indexed: 10/18/2022] Open
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Chen L, Cai A, Wang X, Wang B, Li J. Two- and three-dimensional prenatal sonographic diagnosis of prune-belly syndrome. JOURNAL OF CLINICAL ULTRASOUND : JCU 2010; 38:279-282. [PMID: 20014136 DOI: 10.1002/jcu.20653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report the prenatal diagnosis of 6 cases of Prune-belly syndrome in the 2(nd) trimester. The sonographic diagnosis was based on the findings of oligohydramnios, renal anomalies, and a lower abdominal cystic mass representing the abnormal dilatation of the bladder on conventional 2-dimensional sonographic examination. We discuss the role of Doppler imaging and 3-dimensional sonography as complementary methods to conventional sonography. Four of our 6 cases were confirmed with associated defects.
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Affiliation(s)
- Lizhu Chen
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, China
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Alhawsawi AM, Aljiffry M, Walsh MJ, Peltekian K, Molinari M. Hepatic artery aneurysm associated with prune belly syndrome: a case report and review of the literature. JOURNAL OF SURGICAL EDUCATION 2009; 66:43-47. [PMID: 19215897 DOI: 10.1016/j.jsurg.2008.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 09/21/2008] [Accepted: 10/09/2008] [Indexed: 05/27/2023]
Abstract
Potentially life threatening when they rupture, hepatic artery aneurysms (HAAs) are uncommon and diagnosed at the fifth to sixth decade of life. HAAs are the second most common splanchnic aneurysms after the ones that involve the splenic artery and are more predominant in men than in women with a ratio of 3 to 2. Usually, HAAs are associated with inflammation or traumas to the arteries of the liver. Among the former group, atherosclerosis, arthritis, and collagen vascular disease are the most common, whereas liver biopsy or other radiologic interventions (ie, percutaneous abscess drainage) are frequent iatrogenic causes. HAAs are discovered incidentally in most cases, but some patients can present with intraperitoneal bleeding and hypovolemic shock. The etiology of prune belly syndrome (PBS) is poorly understood, but new evidence suggests that it is caused by mesodermal delay during the fetal development because of an intrauterine injury. We present a case of HAA in a young individual affected by PBS. To our knowledge, this report is the first to describe the existence of these 2 rare conditions in a single patient. We hypothesize that the mesodermal abnormality that involves PBS might be a rare cause of HAA.
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Affiliation(s)
- Abdulelah M Alhawsawi
- Department of Surgery, QEII Medical Center, Dalhousie University, Halifax, Nova Scotia, Canada
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Metwalley KA, Farghalley HS, Abd-Elsayed AA. Prune belly syndrome in an Egyptian infant with Down syndrome: a case report. J Med Case Rep 2008; 2:322. [PMID: 18831729 PMCID: PMC2566579 DOI: 10.1186/1752-1947-2-322] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Accepted: 10/02/2008] [Indexed: 11/16/2022] Open
Abstract
Introduction Prune belly syndrome is a rare congenital anomaly of uncertain aetiology almost exclusive to males. The association between prune belly syndrome and Down syndrome is very rare. Case presentation A 4-month-old Egyptian boy was admitted to our institute for management of acute bronchiolitis. He was born at full term by normal vaginal delivery. His mother, a 42-year-Egyptian villager with six other children, had no antenatal or prenatal care. On examination, the boy was found to be hypotonic. In addition to features of Down syndrome, karyotyping confirmed the diagnosis of trisomy 21. Ultrasound examination of the abdomen showed bilateral gross hydronephrosis with megaureter. Micturating cystourethrography showed grade V vesicoureteric reflux bilaterally with no urethral obstruction. Serum creatinine concentration was 90 μmol/litre, serum sodium was 132 mmol/litre and serum potassium was 5.9 mmol/litre. Conclusion We report an Egyptian infant with Down syndrome and prune belly syndrome. The incidence of this association is unknown. Routine antenatal ultrasonography will help in discovering renal anomalies which can be followed postnatally. Postnatal detection of prune belly syndrome necessitates full radiological investigation to detect any renal anomalies. Early diagnosis of this syndrome and determining its optimal treatment are very important in helping to avoid its fatal course.
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Affiliation(s)
- Kotb A Metwalley
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
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