Urolithiasis in a child 3 years of age and older is characterized by the formation of pebbles (urinary stones) in the urinary tract (renal calyces, pelvis). They appear due to the pathology of the exchange of elements in the body. Learn more about clinical guidelines for urolithiasis in children.
Reason for development
The conditions that initiate the formation of urolithiasis in a child of 5 years (as well as older and younger) can be very different. There are reasons that contribute to the formation of stones in the organs of the genitourinary system, and mechanisms due to which stones directly arise.
Circumstances contributing to the formation of urolithiasis include:
- Natural pathology of the structure of the kidneys. In most situations, stones originate in the kidneys and from there descend into the ureters, bladder, and urethra. Natural physical compression of these organspromotes the formation of stones.
- Impaired metabolism in the body. Natural or received violations in the system of work of the exchange of elements most of all lead to the onset of the disease. These include: oxaluria, galactosemia, uraturia, cystinuria, aminoaciduria. With absolutely all of these pathologies, an excessive number of oxalates, urates, galactose, cysteine are produced, which are deposited in the renal tubules. They are directly considered the base of future kidney stones.
- Genetic propensity. This disease can actually be inherited.
- External conditions or factors that are outside the body. These may include gender, age, characteristics of the geographical location and atmosphere in the region.
Thus, middle-aged people with a sedentary job living in a sultry climate suffer from urinary outflow pathology and urolithiasis three times more than people leading an active lifestyle and living in a cold climate. Such an effect on the body is quite simple to explain - in a hot climate, with an inert state of the body, urine stagnates in the genitourinary organs. A significant concentration of s alts, which appears due to the distinctive features of the atmospheric climate, leads to the formation of the disease.
General Conditions
There are general and local processes in the depths of the body that contribute to the formation of urolithiasis. General conditions include:
- poor metabolism;
- lack of vitamins A and D;
- long stayinjured limbs in a cast or tight bandage (more than three months);
- significant amount of calcium s alts in patient;
- presence of an enterobacterial infection in a child (this includes bacterial pyelonephritis);
- use of certain pharmaceutical substances (antacids for chronic gastritis and ulcers, tetracyclines for enterobacterial diseases, sulfonamides for autoimmune diseases, ascorbic acid for beriberi, glucocorticoids after transplants, for multiple sclerosis and other diseases).
Local Conditions
Various diseases and pathologies are classified as local conditions:
- anatomical pathology of the structure;
- prolonged stay of catheters in the urinary tract;
- weak supply to the urinary organs;
- ureter reflux;
- damage to the dorsal brain resulting in impaired urine output;
- nephroptosis, or omission of the kidney.
The presence or deficiency of one or more conditions does not mean the occurrence of the disease. Only the individual characteristics of the body and the way of life of the child determine the formation of this disease.
Symptoms of kidney stones in children
The symptomatology of the disease depends on the shape, size, localization of stones, quantity and their mobility. Immovable small stones have every chance to be created in the kidneys for years, without bringing a person practically no inconvenience. But one stone with a rough surfaceis able to make its way to the ureters, where it will irritate the mucous membrane and nerve sensors, disrupt the outflow of urine, thereby initiating severe pain.
There are three key symptoms of kidney stones in children:
- pain;
- hematuria (the appearance of blood in the urine - is determined by examining urine or visually);
- discharge of stones or their parts with urine.
In most situations, the first two signs come across. The third is characteristic of small stones that can make their way through the genitourinary tract. The main symptom of urolithiasis is pain. Its occurrence, character, saturation, location depend on the location of the stone and its passage through the genitourinary tract.
Thus, the stones that reside in the kidneys stimulate pain in the lumbar region the most. If the stone is in the lower parts of the ureter, the pain is localized both in the lower abdomen and in the groin. When small stones enter the duct, in some cases, an absolute overlap of its lumen is performed. This gives rise to pain of characteristic intensity and duration, which is called "kidney cramps".
Diagnosis of diseases that caused stones
Diagnosis of urolithiasis is not easy. There is evidence in the medical literature that only one quarter of the total number of patients who arrive at the clinic with suspected renal colic suffer directly from it. ATin other cases, the provocateur of pain is other diseases.
First of all, when making such a diagnosis, the doctor interviews the child and his parents, examines his medical history, measures temperature and blood pressure and performs a medical examination, that is, palpation and percussion (simple tapping) of the abdomen, lower back, chest. One of the signs of kidney pain is pain in the lumbar region and when tapping on the lower edge of the ribs from the left edge.
The intensity of pain depends on the period of discomfort formation - if it is in an acute or chronic stage, the feeling is very significant, if it subsides - insignificant. And if the attack is over, the patient is able to not feel pain at all. Palpation can help to detect where the abdominal muscles are tense, which indicates a painful course in this area. In certain cases, it even turns out to find an enlarged unhe althy kidney.
Blood test
As a rule, usually with urolithiasis, a high number of leukocytes is not traced in the blood (their presence indicates acute inflammatory processes taking place in the body). However, the specialist will pay attention to even the smallest changes in the composition of the blood to determine the presence or absence of the disease in the baby.
Urine test
In the urine, blood clots, protein, s alts, leukocytes, erythrocytes and mesothelium have every chance of being detected. If the number of leukocytes is higher,than red blood cells, therefore, a urinary tract infection is likely.
Daily urinalysis
During the daytime examination, all urine collected by a person for 24 hours (with the exception of the very first, morning portion) is poured into a large container, which is then sent for research. This is a very important type of urine analysis and should be collected responsibly.
X-ray of the gastric cavity and urinary system
On an x-ray of the abdominal cavity, it is possible to find out whether the patient is suffering from acute abdominal pathology, pneumatosis of the intestinal tract, what painful changes have occurred in the kidney. If it is affected, then, as a rule, it looks darker in the picture than he althy. Also, an x-ray can indicate whether an organ is enlarged or not.
Intravenous Urography
In this examination, the patient is placed on an x-ray table, where a radiopaque element is injected into a vein. Then, at the time prescribed by the doctor, a series of x-ray photographs are taken. In some cases, the patient needs to stand up and take pictures in this state.
Ultrasound of the kidneys and bladder
This type of examination makes it possible to establish the position of the urinary tract, the level of expansion of the ureters and renal pelvis, the position of the renal tissue, and also to find out if the patient has stones in the kidneys and ureters, what size they are and where they are located. Of course, if the stone is in the middle thirdureter, it is more difficult to establish its presence with ultrasound due to obstructing the view of the pelvic bones.
Computed tomography
In the event that neither X-ray examinations nor ultrasound can help determine whether there are kidney stones in the patient's body, it is possible to turn to computed tomography of the retroperitoneal region and pelvis.
First Aid
The syndrome in question will always require urgent medical intervention. At the same time, it is necessary to call a professional even if the pain symptoms have become less or completely disappeared. The problem is not only that it is necessary to carry out the relief of pain. The doctor is obliged to conduct a complete examination of the baby, find out the real root cause of the syndrome and, if necessary, provide urgent medical assistance.
Emergency care for urolithiasis consists of three conditions:
- Call the doctor.
- Provide the patient with warmth: he should be seated in a hot bath. Before this, you should make sure that the child has no contraindications to taking a warm bath, otherwise it is possible to use a hot heating pad, which is applied to the affected side.
- It is possible for the patient to provide antispasmodics (for example, "Papaverine" or "Drotaverine"). This will help relax the wall of the ureter. In addition, it is possible to use combined substances with antispasmodic effects.
What substances to prescribe whensigns characteristic of urolithiasis, only a doctor can decide. Before a clear diagnosis of renal pain, the patient should in no case be prescribed painkillers, since other serious diseases, such as an increase in chronic appendicitis, intestinal intussusception, clogging of the gallbladder, and others, can also be the basis of the syndrome. Painkillers in this case will “lubricate” the clinical picture, it will be difficult for the doctor to determine the real root cause.
Treatment
There is no general scheme for the treatment of urolithiasis in children, the doctor will create certain directions only after a complete examination. Therapy of urolithiasis is an urgent help to alleviate the patient's condition. In the event that a patient has an increased body temperature, trembling and impaired reason, then he is immediately hospitalized in a hospital.
If first aid for urolithiasis fails, the patient will undergo laser ureterolithotripsy, catheterization (stenting) of the ureter, puncture nephrostomy, or other surgical treatment. For this purpose, the child is placed in an inpatient surgical or urological department of a medical institution.
Treatment of urolithiasis at high temperature cannot be carried out in domestic circumstances. Most likely, this syndrome indicates the formation of acute pyelonephritis. In this case, immediate hospitalization is indicated. All kinds of thermal operations,definitely contraindicated.
This is when you need emergency transport to the clinic of a patient with an exacerbation of urolithiasis:
- Taking pharmaceutical pain relievers does not reduce or eliminate pain.
- Lack of urine. This is a serious aggravation of the disease and may mean blockage of the urinary tract. This condition can lead to the death of the patient.
- A person has only one kidney.
- The pain syndrome is intense and can be seen from both sides.
How to treat a disease, only a doctor is able to establish on the basis of the patient's history, his general condition and the information acquired during the examination. As you can see, the symptoms and treatment of urolithiasis in children require immediate monitoring by a doctor. This is necessary to avoid serious consequences.
