Urolithiasis in a child 3 years of age and older is characterized by the formation of pebbles (urinous calculi) in the urinary tract (renal calyx, pelvis). They appear due to the pathology of the exchange of elements in the body. You can learn more about the clinical recommendations for urolithiasis in children.
Development reasons
The conditions that initiate the formation of urolithiasis in a child of 5 years (as well as older and younger) can be very different. Distinguish between the causes that contribute to the appearance of stones in the organs of the genitourinary system, and the mechanisms that directly cause stones.
The circumstances contributing to the formation of urolithiasis include:
- Natural pathologies of the structure of the kidneys. In most situations, stones occur in the kidneys and from there descend into the ureters, bladder, and urethra. The natural physical compression of these organs contributes to the appearance of stones.
- Metabolic disorder in the body. Natural or received disturbances in the system of work of the exchange of elements most 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. Directly, they are considered the base of future kidney stones.
- Genetic addiction. This disease can actually be inherited.
- External conditions or factors that reside outside the body. It is possible to classify with them sex, age, characteristic features of a geographical location and atmosphere in the region.
Thus, middle-aged people with sedentary work, living in a hot climate, suffer from pathology of urine outflow and urolithiasis three times more than people who lead an active lifestyle and live in a cold climate. Such an effect on the body is quite simply explained - in a hot climate with an inert state of the body, urinary stasis in the genitourinary organs passes. A significant concentration of salts, which appears due to the distinguishing features of the atmospheric climate, leads to the formation of the disease.
General terms
There are general and local processes in the depths of the body that contribute to the formation of urolithiasis. The general conditions include:
- poor metabolism;
- lack of vitamins A and D;
- prolonged stay of damaged limbs in a cast or tight dressing (more than three months);
- a significant number of calcium salts in the patient;
- the presence of an enterobacterial infection in a child (this includes bacterial pyelonephritis);
- the use of certain pharmaceutical substances (antacids for chronic gastritis and ulcers, tetracyclines for enterobacterial diseases, sulfonamides for autoimmune diseases, ascorbic acid for vitamin deficiencies, glucocorticoids after transplantation, for multiple sclerosis and other diseases).
Local conditions
A variety of diseases and pathologies are attributed to local conditions:
- anatomical pathology of the structure;
- long stay of catheters in the genitourinary tract;
- poor supply of genitourinary organs;
- ureteral reflux;
- damage to the dorsal brain, which leads to impaired urine output;
- nephroptosis, or prolapse of the kidney.
The presence or deficiency of one or more conditions does not mean the onset of the disease. Only the individual characteristic features of the body and the lifestyle of the child determine the formation of this ailment.
Symptoms of urolithiasis in children
Symptoms of the disease depend on the shape, size, location of the stones, the number and their mobility. Immovable small stones have every chance of being created over the years in the kidneys, without bringing any human inconvenience. But one stone with a rough surface is able to make its way into the ureters, where it will irritate the mucous membrane and nerve sensors, disrupt the outflow of urine, thereby initiating strong pain.
There are three key symptoms of urolithiasis in children:
- pain;
- hematuria (the occurrence of blood in the urine - is determined when examining urine or visually);
- discharge of stones or parts thereof with urine.
In most situations, the first two signs come across. The third is characteristic of small pebbles, which can make their way along the genitourinary tract. The main sign of urolithiasis is considered to be pain. Its occurrence, nature, saturation, location depend on the location of the stone and its passage through the urogenital tract.
Thus, stones that are in the kidneys most stimulate pain in the lumbar. If the stone resides in the lower parts of the ureter, the pain is localized both in the lower abdomen and in the groin. When small pebbles get into the duct, in some cases an absolute overlap of its lumen occurs. This gives rise to pain of characteristic saturation and duration, which is called "renal pain."
Diagnosis of diseases that caused stones
Diagnosis of urolithiasis is not an easy task. In the medical literature there is evidence that only one quarter of the total number of patients who arrived at the clinic with suspected renal colic suffers directly from it. In other cases, the pain provocateur is other diseases.
First of all, when making such a diagnosis, the doctor interviews the child and his parents, examines his medical history, measures the temperature and blood pressure, and performs a medical examination, that is, palpation and percussion (simple tapping) of the abdomen, lower back, and chest. One of the signs of kidney pain is soreness in the lumbar region and when tapping the lower edge of the ribs from the left edge.
The intensity of the 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 find 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 unhealthy kidney.
Blood test
As a rule, usually with urolithiasis in the blood a high number of leukocytes is not traced (their presence indicates acute inflammatory processes occurring in the body). However, the specialist will pay attention to even the smallest changes in the composition of the blood in order to determine the presence or absence of the disease in the baby.
Analysis of urine
Blood clots, protein, salts, white blood cells, red blood cells, and mesothelium can be detected in urine. If the number of leukocytes is greater than the red blood cells, therefore, an infection of the urinary system is likely.
Urinalysis
During a day's 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 examination. This is a very important type of urine analysis, the fence of which should be approached 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 suffers 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, the picture looks darker than healthy. An X-ray may also indicate whether the organ is enlarged or not.
Intravenous urography
In this examination, the patient is placed on an X-ray table, where a radiopaque element is introduced into the vein. Further, at the time prescribed by the doctor, a series of X-ray photographs are taken. In some cases, the patient needs to stand on his feet 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 determine whether the patient has stones in the kidneys and ureters, what volume they are and in what place. Of course, if the stone resides in the middle third of the ureter, it is more difficult to establish its presence using ultrasound due to the pelvic bones that are obstructing the view.
CT scan
In the event that neither X-ray studies, nor ultrasound can help determine whether the patient has kidney stones, it is possible to refer to computed tomography of the retroperitoneal region and pelvis.
First aid
The syndrome in question will always require emergency medical attention. At the same time, it is necessary to call a professional even if the pain symptoms have become less or completely gone. The problem is not only that pain relief should be done. The doctor must conduct a full examination of the baby, find out the real root cause of the syndrome and, if necessary, show urgent medical attention.
Emergency care for urolithiasis consists of three conditions:
- Call a doctor.
- Provide the patient with heat: 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 diseased side.
- It is possible to provide the patient with antispasmodics (for example, Papaverine or Drotaverinum). This will help to relax the ureter wall. In addition, it is possible to use combined substances with antispasmodic effects.
What substances should be prescribed for signs characteristic of urolithiasis, only a doctor can decide. Before a clear diagnosis of renal pain, the patient should in no case prescribe painkillers, as the basis of the syndrome can be other serious diseases, such as an increase in chronic appendicitis, intestinal invagination, clogging of the gallbladder and others. In this case, painkillers will “smear” the clinical picture, it will be difficult for the doctor to determine the real root cause.
Treatment
There is no general treatment regimen for urolithiasis in children; the doctor will create certain directions only after a full examination has been completed. Urolithiasis therapy is an urgent aid to alleviate the condition of the patient. If the patient has an elevated body temperature, trembling and impaired reason, then he will immediately be hospitalized in the hospital.
If first aid for urolithiasis has not yielded results, the patient will undergo laser ureterolithotripsy, ureter catheterization (stenting), puncture nephrostomy, or other surgical treatment. For this purpose, the child is placed in a stationary surgical or urological department of a medical institution.
Treatment of urolithiasis at high temperature is impossible to carry 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, of course, are contraindicated.
That's when emergency transportation to the patient’s clinic with an exacerbation of urolithiasis is needed:
- Taking painkillers pharmaceuticals does not reduce or eliminate pain.
- Lack of urine. This is a serious complication of the disease and may mean clogging of the urine pathways. This condition can cause the death of the patient.
- A person has only one kidney.
- The pain syndrome is intense and can be seen from two sides.
How to treat the disease, only a doctor can 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 requires immediate medical attention. This is necessary to avoid serious consequences.