小児腹部腫瘤の診断と治療に関する検討

抄録

47 cases of children with abdominal masses were evaluated regarding their diagnostic and therapeutic problems. They consisted of neoplastic disorders (51%), hydronephrotic disorders (26%), inflammatory disorders (9%), cystic disorders (4%) and other miscellaneous disorders (11%). Intravenous pyelography, B-scope ultrasonography and computed tomography scan were the most valuable and least invasive diagnostic methods for evaluating these children. In cases of neoplastic disorders, angiography gave further informations regarding diagnosis and therapeutic choices. Percutaneous direct pyelography was the most valid method in diagnosing hydronephrotic non-visualizing kidneys. As for therapeutic results, although marked improvement in survival rate was achieved in treating Wilms' tumor, poor prognosis was noted in cases of neuroblastoma. In children presenting with an abdominal mass of advanced hydronephrosis, primary or secondary nephrectomy was indicated in half of the cases. Cases of renal and perirenal abscess did not respond well to conservative treatment and needed surgical interventions.