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Comprehensive Pediatrics Glossary

U

Ureteropelvic Junction Obstruction (UPJ Obstruction)

  • Definition: Congenital or acquired obstruction at the junction of the renal pelvis and ureter, causing impaired urine flow.

  • Epidemiology: Most common cause of antenatal hydronephrosis; more common in males and on the left side.

  • Clinical Features: Often asymptomatic in infancy; may present with abdominal mass, urinary tract infection (UTI), hematuria, flank pain in older children.

  • Investigations: Renal ultrasound (hydronephrosis), diuretic renogram (MAG3 scan) to assess function and drainage, voiding cystourethrogram (VCUG) to rule out reflux.

  • Management: Observation for mild cases, surgical pyeloplasty for severe obstruction or impaired renal function.

  • Complications: Progressive renal damage, recurrent UTIs, hypertension.

Umbilical Hernia (Pediatric)

  • Definition: Protrusion of intra-abdominal contents through the umbilical ring.

  • Epidemiology: Common in infants, especially preterm and low birth weight; higher incidence in African descent.

  • Clinical Features: Soft, reducible swelling at the umbilicus, may increase with crying or straining.

  • Investigations: Clinical diagnosis; ultrasound if atypical features or incarcerated hernia suspected.

  • Management: Most small hernias close spontaneously by age 3–4 years; surgical repair for persistent, large, or symptomatic hernias.

  • Complications: Incarceration, strangulation (rare).

Uveitis (Pediatric)

  • Definition: Inflammation of the uveal tract (iris, ciliary body, choroid).

  • Etiology: Juvenile idiopathic arthritis (most common systemic association), infections, autoimmune diseases.

  • Clinical Features: Redness, photophobia, pain, blurred vision, tearing.

  • Investigations: Slit-lamp examination, ophthalmology referral, ANA testing if JIA suspected, infectious workup if indicated.

  • Management: Topical corticosteroids, cycloplegic drops, systemic immunosuppressants for chronic or severe cases.

  • Complications: Glaucoma, cataracts, band keratopathy, vision loss.

Urinary Tract Infection (UTI)

  • Definition: Infection of the urinary system, commonly bacterial, in children.

  • Etiology: E. coli (most common), Klebsiella, Proteus, Enterococcus.

  • Clinical Features: Fever, dysuria, frequency, urgency, abdominal/flank pain, vomiting in infants.

  • Investigations: Urinalysis, urine culture (clean catch, catheter, or suprapubic aspiration), renal ultrasound if recurrent.

  • Management: Oral or IV antibiotics depending on severity, hydration, treatment of underlying anomaly if present.

  • Complications: Pyelonephritis, renal scarring, hypertension, chronic kidney disease.

Urachal Anomalies

  • Definition: Congenital malformations due to failure of involution of the urachus, connecting bladder to umbilicus.

  • Types: Patent urachus, urachal cyst, urachal sinus, vesicourachal diverticulum.

  • Clinical Features: Umbilical discharge (urine, mucus, or pus), abdominal mass, recurrent infections.

  • Investigations: Ultrasound, voiding cystourethrogram, CT or MRI for complex cases.

  • Management: Surgical excision of urachal remnants, antibiotics if infected.

  • Complications: Recurrent infection, rarely malignancy in older children.

Undescended Testes (Cryptorchidism)

  • Definition: Failure of one or both testes to descend into the scrotum.

  • Epidemiology: More common in premature male infants (30%); usually resolves spontaneously in first 6 months.

  • Clinical Features: Empty scrotum, palpable testis in inguinal canal, small or absent testis.

  • Investigations: Clinical examination, ultrasound or MRI if nonpalpable.

  • Management: Orchiopexy ideally before 12–18 months, hormone therapy (hCG) in selected cases.

  • Complications: Infertility, increased risk of testicular cancer, inguinal hernia, torsion.

Urticaria (Pediatric)

  • Definition: Transient, pruritic wheals due to dermal edema, often immune-mediated.

  • Etiology: Allergic (food, drug), infections, idiopathic, autoimmune.

  • Clinical Features: Raised, erythematous, pruritic lesions that migrate, angioedema may co-occur.

  • Investigations: Clinical diagnosis, allergy testing for recurrent or chronic cases, consider autoimmune workup in chronic urticaria.

  • Management: Avoid triggers, antihistamines (second-generation preferred), corticosteroids for severe or persistent cases.

  • Complications: Angioedema causing airway compromise (rare), chronic urticaria affecting quality of life.

Ureteritis

  • Definition: Inflammation of the ureters, usually secondary to UTI.

  • Clinical Features: Flank pain, dysuria, hematuria, fever if systemic infection.

  • Investigations: Urinalysis, urine culture, ultrasound or CT urography if obstruction suspected.

  • Management: Treat underlying infection with antibiotics, supportive care, address anatomical abnormalities if present.

  • Complications: Pyelonephritis, obstruction, renal scarring.

Umbilical Sepsis (Neonatal)

  • Definition: Infection of the umbilical stump in newborns.

  • Etiology: Bacterial colonization (commonly Staphylococcus aureus, E. coli, Group B Streptococcus).

  • Clinical Features: Redness, swelling, purulent discharge at the umbilicus, fever, irritability.

  • Investigations: Clinical diagnosis, swab for culture if severe.

  • Management: Local antiseptics, systemic antibiotics if spreading or systemic signs.

  • Complications: Omphalitis, sepsis, necrotizing fasciitis (rare).

 

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