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The Perirenal P Sign: A New Roentgenogram Index to the Cause and Treatment of Urinary Ascites in Babies

The Perirenal P Sign: A New Roentgenogram Index to the Cause and Treatment of Urinary Ascites in... Abstract If one sees opaque contrast material around the kidney of an infant with ascites, usually a urinary tract blockade is present. "Ascites" develops because urine fills the abdomen after escaping through tears in the hydronephrotic collecting systems. On roentgenograms, the extravasating urine, made visible with intravenously administered or retrograde contrast material, takes the shape of the letter P (Fig 1, left). The rounded, upper part of the letter is roughly formed by urine trapped around the kidney and lying beneath Gerota's fascia (Fig 2). A translucency in the center of the urine pool is produced by the kidney itself and the dilated ureter adds a tortuous leg to the P. This paper describes a new case of urinary ascites that showed the P sign and considers eight more like it that were found in the literature.1-4 From this review, it appears that the correct therapy for neonatal ascites caused References 1. Dockray, K.T.: Perirenal Contrast Medium: A New Roentgenographic Sign of Neonatal Urinary Ascites , JAMA 193:1121-1123 ( (Sept) ) 1965.Crossref 2. Swain, V.A.J., et al: Perinatal Ascites Due to Extravasation of Urine From Ruptured Kidneys: Approaches to Diagnosis and Treatment , Clin Pediat (Phila) 4:199-202 ( (April) ) 1965.Crossref 3. Moncada, R., et al: Neonatal Ascites Associated With Urinary Outlet Obstruction (Urine Ascites) , Radiology 90:1165-1170 ( (June) ) 1968.Crossref 4. Cywes, S.; Wynne, J.M.; and Louw, J.H.: Urinary Ascites in the Newborn With a Report of Two Cases , Pediat Surg 3:350-356 ( (June) ) 1968.Crossref 5. James, J.A.: Renal Disease in Childhood , St. Louis: C. V. Mosby Co., 1968, p 106. 6. Ellis, D.G.; Fonkulsrud, E.W.; and Smith, J.P.: Congenital Posterior Urethral Valves , Urology 95: 549-554 ( (April) ) 1966. 7. Nesbit, R.M., and Labardini, M.M.: Urethral Valves in the Male Child , Urology 96:218-228 ( (Aug) ) 1966. 8. Minkowski, A., et al: Ascite Foetale avec Hydramnios , Etudes Neonatales 6:25-37 ( (March) ) 1957. 9. Fordyce, W.: Intra-uterine Ascites: Its Obstetrical Significance and Pathology , Teratologia 1: 61-88 ( (July) ) 1894. 10. Braman, R., and Cross, R.R., Jr.: Perinephric Abscess Producing a Pneumonephrogram , Urology 75:194-197 ( (Feb) ) 1956. 11. Rickham, P.P.: Advanced Lower Urinary Obstruction in Childhood , Arch Dis Child 37:122-131 ( (April) ) 1962.Crossref 12. Vollman, R.W.; Keenan, W.J.; and Eraklis, A.J.: Post-traumatic Chylous Ascites in Infancy , New Eng J Med 275:875-877 ( (Oct 20) ) 1966.Crossref 13. Williams, D.I.: "Obstructive Valves in the Posterior Urethra," in University of Texas Southwestern Medical School Urological Seminar (Radiology Grand Rounds), Dallas , (May) 1964, pp 10-11. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

The Perirenal P Sign: A New Roentgenogram Index to the Cause and Treatment of Urinary Ascites in Babies

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Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1970.02100050181021
Publisher site
See Article on Publisher Site

Abstract

Abstract If one sees opaque contrast material around the kidney of an infant with ascites, usually a urinary tract blockade is present. "Ascites" develops because urine fills the abdomen after escaping through tears in the hydronephrotic collecting systems. On roentgenograms, the extravasating urine, made visible with intravenously administered or retrograde contrast material, takes the shape of the letter P (Fig 1, left). The rounded, upper part of the letter is roughly formed by urine trapped around the kidney and lying beneath Gerota's fascia (Fig 2). A translucency in the center of the urine pool is produced by the kidney itself and the dilated ureter adds a tortuous leg to the P. This paper describes a new case of urinary ascites that showed the P sign and considers eight more like it that were found in the literature.1-4 From this review, it appears that the correct therapy for neonatal ascites caused References 1. Dockray, K.T.: Perirenal Contrast Medium: A New Roentgenographic Sign of Neonatal Urinary Ascites , JAMA 193:1121-1123 ( (Sept) ) 1965.Crossref 2. Swain, V.A.J., et al: Perinatal Ascites Due to Extravasation of Urine From Ruptured Kidneys: Approaches to Diagnosis and Treatment , Clin Pediat (Phila) 4:199-202 ( (April) ) 1965.Crossref 3. Moncada, R., et al: Neonatal Ascites Associated With Urinary Outlet Obstruction (Urine Ascites) , Radiology 90:1165-1170 ( (June) ) 1968.Crossref 4. Cywes, S.; Wynne, J.M.; and Louw, J.H.: Urinary Ascites in the Newborn With a Report of Two Cases , Pediat Surg 3:350-356 ( (June) ) 1968.Crossref 5. James, J.A.: Renal Disease in Childhood , St. Louis: C. V. Mosby Co., 1968, p 106. 6. Ellis, D.G.; Fonkulsrud, E.W.; and Smith, J.P.: Congenital Posterior Urethral Valves , Urology 95: 549-554 ( (April) ) 1966. 7. Nesbit, R.M., and Labardini, M.M.: Urethral Valves in the Male Child , Urology 96:218-228 ( (Aug) ) 1966. 8. Minkowski, A., et al: Ascite Foetale avec Hydramnios , Etudes Neonatales 6:25-37 ( (March) ) 1957. 9. Fordyce, W.: Intra-uterine Ascites: Its Obstetrical Significance and Pathology , Teratologia 1: 61-88 ( (July) ) 1894. 10. Braman, R., and Cross, R.R., Jr.: Perinephric Abscess Producing a Pneumonephrogram , Urology 75:194-197 ( (Feb) ) 1956. 11. Rickham, P.P.: Advanced Lower Urinary Obstruction in Childhood , Arch Dis Child 37:122-131 ( (April) ) 1962.Crossref 12. Vollman, R.W.; Keenan, W.J.; and Eraklis, A.J.: Post-traumatic Chylous Ascites in Infancy , New Eng J Med 275:875-877 ( (Oct 20) ) 1966.Crossref 13. Williams, D.I.: "Obstructive Valves in the Posterior Urethra," in University of Texas Southwestern Medical School Urological Seminar (Radiology Grand Rounds), Dallas , (May) 1964, pp 10-11.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1970

References