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Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report

Received: 3 April 2022    Accepted: 5 May 2022    Published: 12 May 2022
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Abstract

Background: The duplex collecting system is one of the congenital anomalies of kidney and urinary tract. It occurs in 0.2-2% of the general population. It can remain asymptomatic or become symptomatic. Affected children may present with urinary tract infections. Treatment options include pharmacological and surgical approaches. Case: We reported a 3-year-old male child, who was referred to Sanglah Hospital with recurrent fever. From the physical examination, we found positive costovertebral angle tenderness. Urinalysis showed high leukocyte sediments (1655/field of view), positive urine culture (Enterococcus gallinarum), and decreased glomerular filtration rate (68.75 ml/minute/1.73 m2). Ultrasonography of the right kidney showed two pelvicalyceal systems with severe hydronephrosis of upper moiety. The intravenous pyelography showed the drooping lily sign in the right kidney. We diagnosed the patient with a complicated urinary tract infection caused by Enterococcus gallinarum, duplex collecting system of right kidney, chronic kidney disease stage II. Antibiotics were administered due to complicated UTI. Open heminephrectomy was done. The patient was discharged in stable condition. Conclusion: The duplex collecting system may cause recurrent urinary tract infection. It can be a risk factor for renal scarring and cause chronic kidney disease. Comprehensive diagnostic workup and multidisciplinary management are needed to promote a good clinical outcome.

Published in American Journal of Pediatrics (Volume 8, Issue 2)
DOI 10.11648/j.ajp.20220802.20
Page(s) 111-114
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Duplex Collecting System, Urinary Tract Infection, Chronic Kidney Disease

References
[1] Wang, JH. Duplex kidney and related abnormalities. Practical Uroradiology. 2010; 21 (2): 96-8.
[2] Ramayani OR, Ritarwan K, Eyanoer PC, Siregar S, Ramayati R. Renal survival analysis of CAKUT and outcomes in chronic kidney disease. Curr Pediatr Res. 2017; 21 (4): 691-95.
[3] Stankovic A. Promising biomarkers in pediatric chronic kidney disease through the kaleidoscope of CAKUT background complexity. Pediatric Nephrology. 2021; 1-5.
[4] Kozlov, VM, Schedl A. Duplex kidney formations: developmental mechanisms and genetic predisposition. F1000 Research. 2020; 2 (9): 1-12.
[5] Halima SJ, Suet KL, Vdant G, Sangeeta K. Congenital anomalies of the kidneys, collecting system, bladder, and urethra. American Academy of Pediatric. 2019: 40 (2): 619-25.
[6] Tamara TC, Jodi SD. Duplicated collecting system. Obstetric Imaging Fetal Diagnosis and Care. 2018; 53 (1): 50-3.
[7] Mishra PO, Prasad R. Congenital anomalies of the kidney and urinary tract: challenges and future prospects. The India Journal of Pediatrics. 2020; 87 (9): 680-81.
[8] Nerli, RB, Sushant D, Murigendra BH, Dixit SN. Antenatally diagnosed upper moiety hydronephrosis in a child with ectopic ureter: A case report. Indian Journal. 2018; 4 (3): 245-47.
[9] Giorlando F, Recal dini C, Leonardi A, Macchi E, Fugazzola A. Duplex collecting system in pelvic kidney-an unusual combination. J Radiol Cse Rep. 2017; 11 (12): 8-15.
[10] Alhaidari OI, Moazin MS, Alhussein RM, Alghaith AA, Almoaigwl FA, Kokandi AA. Indications for pediatric nephrectomy: a restropective hospital-based study on Saudi population. International Journal of Medicine in Developing Countries. 2019; 3 (2): 1-5.
[11] Nneka CO, Mudi A, Levy C, Khumalo T, Moonsamy G. Antibiotics prophylaxis in patients with CAKUT, does it actually prevent UTI? A single center experience at south Africa. Open Journal of Nephrology. 2018; 8: 94-104.
[12] Jain S, Chen F. Developmental pathology of congenital kidney and urinary tract anomalies. Clin Kidney J. 2019; 12 (3): 382-99.
[13] Isert S, Muller, Thumfart J. Factors associated with the development of chronic kidney disease in children with congenital anomalies of the kidney and urinary tract. Frontiers in Pediatrics. 2020; 8 (2): 1-8.
[14] Shahdadi H, Sheyback M, Hosein R, Abbas Balouchi, Bouya S, Gholamhossein M. Causes of Chronic Kidney Disease in Iranian Children: A Meta-Analysis and Systematic Review. Annals of Global Health. 2019; 85 (1): 1–9.
[15] Ballouhey Q, Binet A, Clermidi P, Braik K, Villemagne T, Lardy H. Partial nephrectomy for small children: robot-assisted versus open surgery. International Journal of Urology. 2017; 24 (12): 1-6.
[16] Coran AG, Adzick NS, Krummel MT, Laberge JM, Caldamone A, Shamberger R. Pediatric Surgery Edisi ke-7. Philadelphia: Elsavier; 2012.
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  • APA Style

    Ni Made Dwi Angga Riani, Gusti Ayu Putu Nilawati, Gede Wirya Kusuma Duarsa, Pande Putu Yuli Anandasari, Bagus Ngurah Mahakrishna. (2022). Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report. American Journal of Pediatrics, 8(2), 111-114. https://doi.org/10.11648/j.ajp.20220802.20

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    ACS Style

    Ni Made Dwi Angga Riani; Gusti Ayu Putu Nilawati; Gede Wirya Kusuma Duarsa; Pande Putu Yuli Anandasari; Bagus Ngurah Mahakrishna. Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report. Am. J. Pediatr. 2022, 8(2), 111-114. doi: 10.11648/j.ajp.20220802.20

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    AMA Style

    Ni Made Dwi Angga Riani, Gusti Ayu Putu Nilawati, Gede Wirya Kusuma Duarsa, Pande Putu Yuli Anandasari, Bagus Ngurah Mahakrishna. Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report. Am J Pediatr. 2022;8(2):111-114. doi: 10.11648/j.ajp.20220802.20

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  • @article{10.11648/j.ajp.20220802.20,
      author = {Ni Made Dwi Angga Riani and Gusti Ayu Putu Nilawati and Gede Wirya Kusuma Duarsa and Pande Putu Yuli Anandasari and Bagus Ngurah Mahakrishna},
      title = {Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report},
      journal = {American Journal of Pediatrics},
      volume = {8},
      number = {2},
      pages = {111-114},
      doi = {10.11648/j.ajp.20220802.20},
      url = {https://doi.org/10.11648/j.ajp.20220802.20},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220802.20},
      abstract = {Background: The duplex collecting system is one of the congenital anomalies of kidney and urinary tract. It occurs in 0.2-2% of the general population. It can remain asymptomatic or become symptomatic. Affected children may present with urinary tract infections. Treatment options include pharmacological and surgical approaches. Case: We reported a 3-year-old male child, who was referred to Sanglah Hospital with recurrent fever. From the physical examination, we found positive costovertebral angle tenderness. Urinalysis showed high leukocyte sediments (1655/field of view), positive urine culture (Enterococcus gallinarum), and decreased glomerular filtration rate (68.75 ml/minute/1.73 m2). Ultrasonography of the right kidney showed two pelvicalyceal systems with severe hydronephrosis of upper moiety. The intravenous pyelography showed the drooping lily sign in the right kidney. We diagnosed the patient with a complicated urinary tract infection caused by Enterococcus gallinarum, duplex collecting system of right kidney, chronic kidney disease stage II. Antibiotics were administered due to complicated UTI. Open heminephrectomy was done. The patient was discharged in stable condition. Conclusion: The duplex collecting system may cause recurrent urinary tract infection. It can be a risk factor for renal scarring and cause chronic kidney disease. Comprehensive diagnostic workup and multidisciplinary management are needed to promote a good clinical outcome.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report
    AU  - Ni Made Dwi Angga Riani
    AU  - Gusti Ayu Putu Nilawati
    AU  - Gede Wirya Kusuma Duarsa
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    DO  - 10.11648/j.ajp.20220802.20
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    EP  - 114
    PB  - Science Publishing Group
    SN  - 2472-0909
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    AB  - Background: The duplex collecting system is one of the congenital anomalies of kidney and urinary tract. It occurs in 0.2-2% of the general population. It can remain asymptomatic or become symptomatic. Affected children may present with urinary tract infections. Treatment options include pharmacological and surgical approaches. Case: We reported a 3-year-old male child, who was referred to Sanglah Hospital with recurrent fever. From the physical examination, we found positive costovertebral angle tenderness. Urinalysis showed high leukocyte sediments (1655/field of view), positive urine culture (Enterococcus gallinarum), and decreased glomerular filtration rate (68.75 ml/minute/1.73 m2). Ultrasonography of the right kidney showed two pelvicalyceal systems with severe hydronephrosis of upper moiety. The intravenous pyelography showed the drooping lily sign in the right kidney. We diagnosed the patient with a complicated urinary tract infection caused by Enterococcus gallinarum, duplex collecting system of right kidney, chronic kidney disease stage II. Antibiotics were administered due to complicated UTI. Open heminephrectomy was done. The patient was discharged in stable condition. Conclusion: The duplex collecting system may cause recurrent urinary tract infection. It can be a risk factor for renal scarring and cause chronic kidney disease. Comprehensive diagnostic workup and multidisciplinary management are needed to promote a good clinical outcome.
    VL  - 8
    IS  - 2
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Author Information
  • Department of Pediatrics, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Pediatrics, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Urology, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Radiology, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Pediatrics, Faculty of Medicine, Udayana University, Denpasar, Indonesia

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