Dust Mites

December 19, 2011 Posted by

What is a dust mite allergen?

Dust mites are microscopic organisms that can live and thrive throughout homes and schools. The mites and their waste products thrive in the following:

  • Bedding
  • Upholstered furniture
  • Carpets

dust mite

Dust mites thrive in warm, humid conditions and feed on the shed scales of human skin. The waste products of the dust mite are what produce allergic reactions and asthma. The best way to prevent dust mites is to limit your child’s exposure. Be sure to pay special attention to the bedroom, especially the mattress and pillows.
iconWays to decrease dust mite exposure include the following:

Beds
 – Every bed in your house should have wooden or metal frames. Do not allow your child to sleep on a couch, sofa, or hide-a-bed. If your child has asthma and sleeps in a bunk bed, he/she should sleep in the top bunk.

Mattress/Box Spring
 – Place all mattresses and box springs in a zippered, and tape over the zippers with electrical or duct tape.

Pillows -
 Encase pillows in zippered, dust-proof covers. Pillows should be made of Dacron or other synthetic fiber. Do not use foam, feather, or “Down” pillows.

Bedding
 – Avoid wool or down blankets. Wash all bedding (sheets, pillowcases, blankets)
in hot water. Cold water will not kill the dust mites. Dry all clothes and bedding in the dryer to avoid pollen sticking to them when on a clothesline.

Floor coverings
 – If possible, remove wall-to-wall carpeting. If not, vacuum the carpet frequently (at least twice a week). If your child has asthma, only vacuum when your child is away and will not return to the room for several hours after you have finished. Substitute multi-layered vacuum bags for regular single layer bags. Small, washable cotton rugs may be used if washed often. Wood, tile, or vinyl flooring without a rug is best, and they should be mopped at least weekly.

Furnace (heating) – 
Electric or gas heat is recommended. Do not use wood stoves or kerosene heaters. Change the air filters on the furnace every month. Cover all furnace outlets in the room with or cover the outlets with 10 thicknesses of cheesecloth or muslin. This will catch dust in the furnace air. Change the cheesecloth when it gets dusty underneath (about every two weeks).

Stuffed animals
 – Limit the number of stuffed animals to 2 or 3. Keep all stuffed animals off of the bed and wash them about once a month to remove dust mite allergens. Stuffed animals can also be put in a hot dryer for 20 minutes to remove dust mites.

Hand-Foot-Mouth Disease

December 17, 2011 Posted by

What is hand-foot-mouth disease (HFMD)?

Hand-foot-mouth disease is an illness caused by a virus that results in a distinctive rash – small, blister-like bumps in the mouth, and on the hands and feet. The blisters may also appear in the diaper area and on the legs and arms. The lesions in the mouth usually appear on the tongue, the sides of the cheeks, or near the throat.

hand-foot -mouth disease

What causes hand-foot-mouth disease?

Hand-foot-mouth disease is caused by a virus. The most common viruses that cause hand-foot-mouth-disease include the following:

  • Coxsackie virus
  • Other enteroviruses

This disease is very common in children, particularly children under the age of 10. It is seen most often in the summer and fall. The virus is usually spread through fecal-oral contact, although other modes of transmission have been reported. Good hand washing is necessary to help prevent the spread of the disease.

What are the symptoms of hand-foot-mouth disease?

The following are the most common symptoms of hand-foot-mouth disease. However, each child may experience symptoms differently. Symptoms may include:

  • Blister-like bumps in the mouth (on the tongue, the cheeks, and near the throat and tonsils)
  • Blister-like bumps on the palms of the hands and the soles of the feet; bumps may also be seen on the arms, legs, and diaper area.
  • Mild fever

How is hand-foot-mouth disease diagnosed?

Hand-foot-mouth disease is usually diagnosed based on a complete history and physical examination of your child. The rash of hand-foot-mouth disease is unique, and usually allows for a diagnosis simply on physical examination.

Treatment for hand-foot-mouth disease:

    Specific treatment for hand-foot-mouth disease will be determined by your child’s physician based on:

  1. Your child’s age, overall health, and medical history.
  2. Extent of the disease.
  3. Your child’s tolerance for specific medications, procedures, or therapies.
  4. Expectations for the course of the disease.
  5. Your opinion or preference.

The goal of treatment for hand-foot-mouth disease is to help decrease the severity of the symptoms. Since it is a viral infection, antibiotics are ineffective.

Treatment may include:

  • Increased fluid intake to prevent dehydration – provide cool, iced fluids in small amounts frequently acetaminophen for any fever.
  • Proper hand washing is essential in helping to prevent the disease from being spread to other children.

Hemifacial Microsomia

December 17, 2011 Posted by

What is hemifacial microsomia (HFM)?

Hemifacial microsomia (HFM) is a condition in which the tissue on one side of the face is underdeveloped, affecting primarily the aural (ear), oral (mouth), and mandibular (jaw) areas. Sometimes, both sides of the face can be affected and may involve the skull, as well as the face.

Hemifacial microsomia is also known as Goldenhar syndrome, brachial arch syndrome, facio-auriculo-vertebral syndrome (FAV), oculo-auriculo-vertebral spectrum (OAV), or lateral facial dysplasia.

What are the different types of HFM?

The deformity in hemifacial microsomia varies greatly in the degree of severity and in the area of the face involved. The disorder varies from mild to severe. In the more severe cases, the following structures are underdeveloped:

  • The external and middle ear
  • The side of the skull
  • The thickness of the cheek tissue
  • The upper and lower jaws
  • The teeth
  • Some of the nerves that allow facial movement
  • In the milder forms, only some of the structures are affected and to a lesser degree.

What causes hemifacial microsomia?

Hemifacial microsomia usually occurs sporadically (occurs by chance), but is thought to be inherited in some families. This is because of the many familial (cases occurring more than once in a family) cases reported.

The following patterns of inheritance have been observed:

Autosomal- (Dominant 
Autosomal) dominant means that one gene is necessary to express the condition, and the gene is passed from parent to child with a 50 percent risk for each pregnancy. Males and females are equally affected and there is great variability in expression of the gene. In other words, a parent may unknowingly have a very mild sign of hemifacial microsomia, such as preauricular tags (skin tags by the ear), but the child is more severely affected. The family may not come to the attention of a geneticist until the birth of the child with a more severe condition. Other relatives with mild expression of the gene are often discovered at that time, confirming autosomal dominant inheritance.

Autosomal (Recessive 
Autosomal) recessive means that two copies of the gene are necessary to express the condition, one inherited from each parent, who are carriers. Carrier parents have a one in four, or 25 percent, chance with each pregnancy to have a child with hemifacial microsomia. Males and females are equally affected.

Multifactorial inheritance means that “many factors” are involved in causing a birth defect. The factors are usually both genetic and environmental. Often one gender (either male or female) is affected more frequently than the other in multifactorial traits. There appears to be a different “threshold of expression,” which means that one gender is more likely to show the problem, over the other gender. In hemifacial microsomia, males are slightly more likely to be affected than females.

Observations made from families who have one child with hemifacial microsomia show that the overall chance for another child to be born with hemifacial microsomia is about 2 to 3 percent. Parents and other family members should have a thorough evaluation to help give more definite recurrence information. In addition, hemifacial microsomia is sometimes found in children with various types of chromosome abnormalities. Chromosomes are the structures in our cells that carry our genes. Genes determine traits such as blood type and eye color. Chromosome abnormalities are usually sporadic (occur by chance).

Which parts of the facial bone are involved?

One of the most obvious problems in hemifacial microsomia is the underdevelopment of the upper and lower jaws on the affected side. It may appear that your child’s mouth slants upward toward the involved side. Often the forehead and cheek are flattened on the affected side with one orbit (eye socket) smaller than normal.

What other areas of the face are affected?

Other areas of your child’s face that may be affected by hemifacial microsomia include the following:
Your child may have unequal cheek fullness (asymmetry) because of the underdeveloped fat and muscle. Some parts of the face may not move normally, which may cause a “crooked” smile.

There is a wide range of ear abnormalities associated with HFM. Your child may have a mildly misshapen ear or almost complete absence of the external ear (atresia). Small tags of skin may also be present in front of the ear(s).

Occasionally, the central nervous system is affected, causing parts of the face to not move symmetrically (equally).

How is HFM diagnosed?

HFM is typically diagnosed after a comprehensive medical history and physical examination by a geneticist. There is not a blood test to diagnose HFM. Because the spectrum of severity is so wide, the diagnosis should come from an experienced geneticist skilled in diagnosing craniofacial anomalies. CT scans and x-rays of the face may also be ordered for accurate diagnosis.

Diagnostic tests that may be performed to confirm the diagnosis of hemifacial microsomia include:
x-rays of the head – a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues and bones of the head onto film.

Computed tomography scan (Also called a CT or CAT scan.) of the head – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the head. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

Treatment for HFM:

Specific treatment for HFM is extremely variable because there are so many differences in the types of HFM. Any child with suspected HFM should be evaluated by a craniofacial anomalies team. Each of the specialists will have a proposed treatment plan depending on the severity of your child’s specific physical findings.

After a diagnostic evaluation and meeting with a craniofacial team, the following treatment options may be discussed:

  • For severe underdevelopment of the lower jaw, reconstruction using a bone graft taken from the ribs may be suggested.
  • Another possibility to lengthen the underdeveloped mandible (jaw) would be to place a device on the jaw for bone distraction. This technique avoids the need for bone grafts.
  • The external ear is usually reconstructed between the ages of 6 to 8 years. This is a multiple stage process with several months between each surgery.
  • Further surgery in the soft tissue of the cheek to increase symmetry, or possibly jaw surgery, may be needed when your child reaches adolescence.

Because hemifacial microsomia involves so many areas of the body, many specialists are required, including the following:

  • The craniofacial surgeon performs the jaw surgery and ear reconstruction.
  • The geneticist counsels the patient and family regarding the recurrence risks of hemifacial microsomia.
  • The nurse coordinator acts as a liaison between the family and many specialists and assists in patient education.
  • The ophthalmologist evaluates vision and eye movements.
  • The orthodontist follows the jaw growth and alignment of teeth to assist the surgeon in an optimal result of jaw surgery.
  • The otolaryngologist assesses hearing abnormalities and coordinates middle ear surgery or hearing aides, if needed.
  • The speech therapist evaluates the speech development and coordinates speech therapy, if necessary.

Heart Murmurs

October 11, 2011 Posted by

What is a heart murmur?
Murmurs are sounds made by blood circulating through the heart’s chambers or valves, or through blood vessels near the heart.

What causes a heart murmur?
Heart murmurs may be caused by a number of factors or diseases, including the following:
defective heart valves holes in the heart walls (atrial septal defect or ventricular septal defect.)

  • Surgical repair of congenital (present at birth) heart defects.
  • Fever anemia (a decrease in the red cells in the blood.)

What are the different types of murmurs?
Your child’s physician will evaluate a murmur based on several factors. Murmurs are analyzed for pitch, loudness, and duration. They also are graded according to their intensity (on a scale of one to six, with one being very faint and six being very loud.)

heart murmur

Types of murmurs include the following:

  • Systolic murmur – a heart murmur that occurs during a heart muscle contraction. Systolic murmurs are divided into ejection murmurs (due to blood flow through a narrowed vessel or irregular valve) and regurgitant murmurs.
  • Diastolic murmur – a heart murmur that occurs during heart muscle relaxation between beats. Diastolic murmurs are due to a narrowing (stenosis) of the mitral or tricuspid valves, or regurgitation of the aortic or pulmonary valves.
  • Continuous murmur – a heart murmur that occurs throughout the cardiac cycle.

Murmurs related to a congenital (present at birth) heart defect or other problem involving the heart structures will be heard the loudest in the area of the chest where the problem occurs. Some large defects have almost no murmur in the newborn due to normally elevated pressures in the blood vessels in the lungs. Murmurs may be inconsistent and difficult to hear in an infant who is agitated or crying. Thus, murmurs may be missed or not detected.

Do all murmurs signify heart disease?

Not all heart murmurs are symptoms of heart disease. Sometimes, a murmur may be heard in a normal child who has a fever or who is anemic; these murmurs often go away when the underlying problem is treated.

Some children have what is known as an innocent murmur. These murmurs are not related to congenital heart defects, and usually resolve by the time a child reaches adulthood. If your child’s physician hears an innocent murmur, he/she may want to perform additional tests to ensure a heart defect is not present. A child with an innocent murmur can live a normal life and be as active as any other healthy child.

Find a Pulse Oximeter to monitor your child’s Heart rate and Oxygen Saturation Levels

What is Biliary Atresia?

March 31, 2011 Posted by

Biliary atresia is a chronic, progressive liver problem that becomes evident shortly after birth. Tubes inside and outside the liver, called bile ducts, normally allow a liquid produced by the liver called bile to drain into the intestines and kidneys. Bile aids in digestion and carries waste products from the liver to the intestine and kidneys for excretion. In biliary atresia, bile ducts that are located inside or outside the liver are blocked. When the bile is unable to leave the liver through the bile ducts, the liver becomes damaged and many vital body functions are affected.

The cause of biliary atresia is not known. Some researchers and physicians believe that babies are born with biliary atresia, implying the problem with the bile ducts occurred during pregnancy while the liver was developing. Others believe that the disease begins after birth, and may be caused by exposure to infections or exposures to toxic substances.

Biliary atresia does not seem to be linked to medications the mother took, illnesses the mother had, or anything else the mother did during her pregnancy. Currently, there is not a genetic link known for biliary atresia.

The disease is unlikely to occur more than once in a family.

  • Biliary atresia is the most common cause of chronic liver disease in neonates.
  • Biliary atresia occurs once in every 15,000 births.
  • Asian populations are most frequently affected. African Americans are affected approximately twice as much as Caucasians. 

Biliary Atresia

Biliary atresia causes liver damage and affects numerous important processes that allow the body to function normally. It is a life-threatening disease and is fatal without treatment.

Infants with biliary atresia usually appear healthy at birth. Most often, symptoms develop between two weeks to two months of life, and may include:

  • Jaundice
  • Dark urine
  • Light colored stools
  • Distended abdomen
  • Weight loss

Jaundice is a yellow discoloration of the skin and whites of the eyes due to an abnormally high level of bilirubin (bile pigment) in the bloodstream, which is then excreted through the kidneys. High levels of bilirubin may be attributed to inflammation or other abnormalities of the liver cells, or blockage of the bile ducts. Jaundice is usually the first sign, and sometimes the only sign, of liver disease.

Symptoms of biliary atresia may resemble other liver conditions or medical problems. Please consult your child’s physician for a diagnosis.

A physician or healthcare provider will examine your child and obtain a medical history. Several diagnostic procedures are done to help evaluate the problem and may include the following:

  • Blood tests
  • Liver enzymes 
- elevated levels of liver enzymes can alert physicians to liver damage or injury, since the enzymes leak from the liver into the bloodstream under these circumstances.
  • Bilirubin – bilirubin is produced by the liver and is excreted in the bile. Elevated levels of bilirubin often indicate an obstruction of bile flow or a defect in the processing of bile by the liver.
  • Albumin and total protein
 Below-normal levels of proteins made by the liver are associated with many chronic liver disorders.
  • Clotting studies, such as prothrombin time (PT) and partial thromboplastin time (PTT)
Tests that measure the time it takes for blood to clot. Blood clotting requires vitamin K and proteins made by the liver.
  • Liver cell damage and bile flow obstruction can both interfere with proper blood clotting.
  • Viral studies – including hepatitis and HIV
Checking for viruses in the bloodstream can help determine the cause of the liver problems.

Blood culture
 – Checking for bacterial infection in the bloodstream that can affect the liver may be used to diagnose biliary atresia. Also imaging tests:

  • Abdominal ultrasound – a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view the liver, gallbladder, and bile ducts.
  • Hepatobiliary (HIDA) scan – a low radioactive isotope (technetium) is injected into the child’s vein. The liver and intestine are scanned by a nuclear medicine machine. If the isotope passes through the liver into the intestine, the bile ducts are open and the child does not have biliary atresia.

The test that gives the most definitive diagnosis is a liver biopsy. A tissue sample is taken from your child’s liver and examined for abnormalities, allowing biliary atresia to be distinguished from other liver problems.

Specific treatment for biliary atresia will be determined by your child’s physician based on the following:

  • The extent of the problem
  • Your child’s age, overall health, and medical history
  • Your child’s tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the problem
  • The opinion of the physicians involved in the child’s care
    your opinion and preference.

Biliary atresia is an irreversible problem. There are no medications that can be given to unblock the bile ducts or to encourage new bile ducts to grow where there were none before. Until that happens, biliary atresia will not be curable. However, two different operations can be done that will allow the child with biliary atresia to live longer and have a better quality of life. Your child’s physician can help determine whether either of these operations are an option.

Kasai portoenterostomy
, this operation connects the bile drainage from the liver directly to the intestinal tract. It is most successful when done before an infant is 8 weeks old. The Kasai procedure is helpful because it can allow a child to grow and remain in fairly good health for several years. Eventually, cholestasis (backup of bile in the liver) will occur, causing liver damage. Up to 80 percent of children who undergo the Kasai portoenterostomy will eventually need to have a liver transplant.

Liver transplant
- a liver transplant operation removes the damaged liver and replaces it with a new liver from a donor. The new liver can be either:

  • A whole liver, received from a child who has died.
  • Part of a liver, received from a child who has died or
    part of a liver, received from a relative or other person whose tissue types match the child’s tissue type.

After surgery, the new liver begins functioning and the child’s health often improves quickly. After a liver transplant, children will need to take medications to prevent the body from rejecting the new organ. Rejection occurs due to one of the body’s normal protective mechanisms that helps fight against invasion of viruses, tumors, and other foreign substances. Anti-rejection medications are taken in order to prevent this normal response of the body from fighting against the transplanted organ. Frequent contact with the physicians and other members of the transplant team is crucial after a liver transplant.

Before your child has either one of these operations, nutrition may be a problem. With biliary atresia, not enough bile reaches the intestine to assist with the digestion of fats in the diet. Protein deficiencies may occur due to liver damage. Vitamin deficiencies may also occur. Children with liver disease require more calories than a normal child because of a faster metabolism.

Your physician may recommend that a pediatric nutritionist make recommendations regarding your child’s diet. Nutritional guidelines may include the following:

  • Provide your child with a good, well-balanced diet.
  • Supplement your child’s diet with vitamins, as directed by your child’s physician.

MCT (medium-chain triglyceride) oil or infant formulas with MCT (Portagen® or Pregestimil®) may be recommended to add extra calories to help your child grow. Medium-chain triglycerides are more easily digested without bile than other types of fats. MCT oil can be added to foods and liquids that your child eats.
Provide your child with high-calorie liquid feedings, as directed by your child’s physician. Some children with liver disease become too sick to eat normally. In this case, your physician may recommend that your child have liquid feedings given to help meet his/her body’s requirements. These feedings are given through a tube called a nasogastric tube (NG) that is guided into the nose, down the esophagus, and into the stomach. A high-calorie liquid can be given through the tube to supplement your child’s diet if he/she is able to eat only small amounts of food, or to replace meals if your child is too sick to eat.

After surgery, your child’s digestion may return to normal, or you may still need to give extra vitamins and/or work with your child’s diet. Please consult your child’s physician for recommendations.
Many factors affect the long-term outlook for these children.

Some of them include:

  • The extent of bile duct damage.
  • The age at which either a Kasai portoenterostomy or liver transplant is done.
  • The extent of liver damage that has occurred.
  • The overall health of your child.

Over 65 percent of children who have the Kasai portoenterostomy will eventually require a liver transplant. After liver transplant, the child’s health will usually improve; however, a rigorous medical regimen must be followed.

Rubeola (Measles)

March 30, 2011 Posted by

Rubeola, also called 10-day measles, red measles, or measles, is a viral illness that results in a viral exanthem. Exanthem is another name for a rash or skin eruption. Rubeola has a distinct rash that helps aid in the diagnosis. It is spread from one child to another through direct contact with discharge from the nose and throat. Sometimes, it is spread through air-borne droplets from an infected child. This is a very contagious disease that usually consists of a rash, fever, and cough.

Measles virus, the cause of measles, is classified as a Morbillivirus. It is mostly seen in the winter and spring. Rubeola is preventable by proper immunization with the measles vaccine.
It may take between eight to 12 days for a child to develop symptoms of rubeola after being exposed to the disease. It is important to know that a child is contagious one to two days before the onset of signs and symptoms and three to five days after the rash develops. Therefore, children may be contagious before they even know they have the disease.

rubeola- measles

During the early phase of the disease (which lasts between one to four days), symptoms usually resemble those of an upper respiratory infection.

The following are the common symptoms of rubeola. However, each child may experience symptoms differently.
Symptoms may include:

  • Hacking cough
  • Redness and irritation of the eyes
  • Fever
  • Small red spots with white centers appear on the inside of the cheek (usually occur two days before the rash on the skin appears)
  • Rash – deep, red, flat rash that starts on the face and spreads down to the trunk, arms, and legs.

The rash starts as small distinct lesions, which then combines as one big rash. After three to four days, the rash will begin to clear leaving a brownish discoloration and skin peeling.

The most serious complications from rubeola include the following:

  • Ear infections
  • Pneumonia
  • Croup
  • Inflammation of the brain

The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult your child’s physician for a diagnosis.

Rubeola is usually diagnosed based on a complete medical history and physical examination of your child. The lesions of rubeola are unique, and usually allow for a diagnosis simply on physical examination.

In addition, your child’s physician may order blood or urine tests to confirm the diagnosis.
Specific treatment for rubeola will be determined by your physician based on:

  • Your child’s age, overall health, and medical history
    extent of the disease.
  • Your child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Aspirin and the Risk of Reye Syndrome in Children:
Do not give aspirin to a child without first contacting the child’s physician. Aspirin, when given as treatment for children, has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Therefore, pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

The goal of treatment for rubeola is to help prevent the disease, or decrease the severity of the symptoms. Since it is a viral infection, there is no cure for rubeola. Treatment may include:

  • Increased fluid intake
  • acetaminophen (such as children’s tylenol) for fever (DO NOT GIVE ASPIRIN)

If your child was exposed and has not been immunized, your child’s physician may give the vaccine to the child within 72 hours to help prevent the disease.

Since the use of the rubeola (or measles) vaccine, the incidence of measles has decreased by 99 percent. About 5 percent of measles are due to vaccine failure. The measles vaccine is usually given in combination with the mumps and rubella vaccine. It is called the MMR. It is usually given when the child is 12 to 15 months old and then again between 4 to 6 years of age.

Other ways to prevent the spread of rubeola:
Children should not attend school or daycare for four days after the rash appears.
Assure all of your child’s contacts have been properly immunized.

Megaureter

March 30, 2011 Posted by

Megaureter is an abnormality of one or both of the ureters of a child. Ureters are the two funnel-shaped tubes that carry urine from the kidneys to the bladder. A megaureter refers to an expanded or widened ureter that does not function normally. The size of a megaureter is usually greater than 7 millimeters in diameter.

Complications associated with megaureter include reverse flow of urine into the kidneys, and pooling of urine inside the ureter that does not drain. The pooling can cause a child to develop a urinary tract infection. In some children, complications from megaureter can cause kidney damage and failure.

A megaureter that is not associated with other problems occurs during fetal development. It occurs when a section of the ureter, which is normally a muscular layer of tissue, is replaced by stiff, fibrous tissue. In the absence of a muscular layer, normal peristalsis (worm-like movement of the ureter that propels urine towards the bladder) cannot occur.

Megaureter can occur alone, but usually occurs in combination with other disorders, such as prune belly syndrome.

The syndrome may occur in varying degrees, possibly causing blockage, and reverse flow of urine. However, each child may experience symptoms differently. The symptoms of a megaureter may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis.

The severity of the problem often determines how a diagnosis is made. Often a megaureter is diagnosed by ultrasound while a woman is still pregnant. After birth, some children may have other problems that may suggest the presence of megaureter. Children who are diagnosed later often have developed urinary tract infections that require evaluation by a physician. This may prompt your child’s physician to perform further diagnostic tests, which may include the following:

Anatomy Megaureter


  • Intravenous pyelogram (IVP) – a diagnostic imaging technique which uses an x-ray to view the structures of the urinary tract. An intravenous contrast of dye is given so that the structures can be seen on film. An IVP also reveals the rate and path of urine flow through the urinary tract.
  • Voiding cystourethrogram (VCUG) – a specific x-ray that examines the urinary tract. A catheter (hollow tube) is placed in the urethra (tube that drains urine from the bladder to the outside of the body) and the bladder is filled with a liquid dye. X-ray images will be taken as the bladder fills and empties. The images will show if there is any reverse flow of urine into the ureters and kidneys.
  • Abdominal ultrasound – a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
  • Diuretic renal scan – a diagnostic nuclear imaging technique that is conducted by injecting a radioactive fluid into the vein. The radioactive material is then carried to the kidneys where it gives off signals that can be picked up by cameras. Midway during the procedure a diuretic medication is given to speed up urine flow through the kidneys. This helps detect any area of blockage in the urinary tract.
  • Blood tests – (to assess your child’s electrolytes and to determine kidney function).
  • Specific treatment for megaureter will be determined by your child’s physician based on:

    • Your child’s age, overall health, and medical history
      the extent of the disease
    • Your child’s tolerance for specific medications, procedures, or therapies
      expectations for the course of the disease.
    • Your opinion or preference

    Your child may require antibiotic therapy as a precaution to prevent future urinary tract infections.
    In some cases, medical intervention is not required because the megaureter will resolve on its own over time. If there is a blockage of the urinary tract, however, a megaureter may require surgical intervention. The surgical procedure involves removing the section of the ureter that is abnormal, reducing it, and reconnecting the ureter.