Abstract
There are various causes of Reno Vascular Hypertension in children reported in the literature. Amongst these, Page kidney gets a rare mention. This phenomenon is a result of the accumulation of blood or urine in the perinephric or subcapsular space, resulting in compression of renal parenchyma, microvascular ischemia, alteration in the renin-angiotensin apparatus, and high renin hypertension. It has been well documented and studied in adults. Only a few cases are reported in the paediatric population. We report a rare presentation of Page kidney in a 5 year 8 months old girl. She initially presented with Dietl's crisis secondary to left Pelviureteric Junction obstruction (PUJO) causing massive hydronephrosis. She developed Page kidney phenomenon after spontaneous rupture of the pelvicalyceal system formed a tight compressive urinoma. She was managed successfully with internal JJ stenting and ultrasound-guided aspiration of the urinoma followed by elective delayed Pyeloplasty. To our knowledge, this is the first documented case of Page kidney in a child with severe PUJO.
Highlights
Page kidney refers to the occurrence of hypertension secondary to renal compression and is usually associated with a subcapsular or perinephric hematoma [1]
We report a case of Page kidney in a child with Pelviureteric Junction obstruction (PUJO), developed after spontaneous rupture of the pelvicalyceal system formed a massive subcapsular urinoma
This collection resulted in displacement of the left kidney and compression of left renal parenchyma—The clinical and imaging features were suggestive of Page kidney (Figure 2)
Summary
Page kidney refers to the occurrence of hypertension secondary to renal compression and is usually associated with a subcapsular or perinephric hematoma [1]. The first documented clinical case of Page kidney was reported in 1955 by Engel and Page [2]. Thereafter, many cases were reported, mainly in adults following trauma. We report a case of Page kidney in a child with PUJO, developed after spontaneous rupture of the pelvicalyceal system formed a massive subcapsular urinoma
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