Percutaneous nephrolithotomy for 27-month-old baby

The patient was admitted to the hospital in a state of constant crying and pink urine. Doctors performed an abdominal ultrasound and CT scan and found a relatively large left kidney stone measuring 10x8mm, with no urinary system abnormalities...

The child's father added that the family discovered the child had this dangerous disease during an abdominal ultrasound when he was only 6 months old in Da Nang city. At that time, the family was extremely worried and confused, so they took the child to many hospitals. Most of the doctors suggested open surgery to remove the kidney stones for the child.

Doctor Nguyen Dinh Lien, who directly performed the surgery on the child, shared: The difficulty of this surgery is that the patient is too small, so the instruments must be specialized and some alternative instruments must be used. Compared to the surgery on the elderly using the technique of percutaneous endoscopic lithotripsy with a small tunnel (18Fr equivalent to 6mm) or a standard tunnel (24Fr equivalent to 8-10mm), for this pediatric patient, the doctors used the technique of percutaneous endoscopic lithotripsy with a super small tunnel (under 3mm) into the left kidney, fragmenting the stone with a laser, and washing to remove all the stone fragments...

12 hours after surgery, the child was able to move and eat again. The post-operative film showed that the stones were clean compared to the old film. Doctor Nguyen Dinh Lien said that kidney stones are a common disease in urinary tract diseases. Kidney stones in children are not given proper attention by the people because the rate of kidney stones in children is much lower than in adults. However, the rate of kidney stones in children is increasing. In children, kidney stones are related to genetic, metabolic, and anatomical causes. Ignoring genetic factors, the number of children with this disease is currently due to diet and lifestyle such as eating a lot of fast food with too much salt, drinking little water, and being sedentary, which are the causes of rapid kidney stones in children, especially children with metabolic disorders. In addition, children often have urinary tract infections, have abnormalities in natural narrowings of the urinary tract (narrowing of the renal pelvis-ureter junction, narrowing of the bladder-ureter junction) or diseases that obstruct urine expulsion such as neurogenic bladder... which are also favorable conditions for stone formation.

Common symptoms of urinary tract stones are pain in the lower back, little urine, blood in the urine, especially if there is a family history of kidney stones. In young children, they are easily irritated, fussy, vomit, and often have urinary tract infections, which are manifested by crying and screaming every time they urinate.

News and photos: THANH XUAN

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