Pyelocalyal dilation, also known as ectasia of the renal chalices or enlarged kidney, is characterized by the dilation of the inner portion of the kidney. This region is known as the renal pelvis, as it is shaped like a funnel and has the function of collecting urine and taking it towards the ureters and the bladder, as shown in the figure.
This dilation usually happens due to increased pressure in the urinary tract due to blockage in the passage of urine, which can be caused by deformities in the structures of the urinary tract, which is more common in children, or by situations such as stones, cysts, tumors or severe kidney infection, which can also occur in adults. This change does not always cause symptoms, but pain in the abdomen or changes to urinate, for example, may arise.
Pyelocalyal dilation, which is also called hydronephrosis, can be diagnosed through imaging exams of the region, such as ultrasound, which can demonstrate the degree of dilation, the size of the kidney and whether its size causes compression of the kidney tissues.. Pyelocalytic dilation on the right is generally more frequent, but it can also occur in the left kidney, or in both kidneys, being bilateral.
What are the causes
There are several causes for obstruction of the passage of urine through the pyelocalytic system, and the main ones are:
The causes of pyelocalyal dilatation in the newborn are still unclear and, in most cases, it tends to disappear after the baby is born. However, there are cases caused by anatomical deformities in the baby's urinary tract, which are more serious situations.
Pielocalicial dilation in adults, on the other hand, usually occurs as a consequence of cysts, stones, nodules or cancer in the kidney region or in the ureters, which lead to the blockage of the passage of urine and its accumulation, causing dilation of the renal pelvis. Check out more causes and how to identify in Hydronephrosis.
How to confirm
Pyelocalocial dilation can be diagnosed through ultrasound or ultrasound examination of the renal system. In some cases, dilation can be detected in the baby while still in the mother's womb, on routine ultrasound exams, but it is usually confirmed after the baby is born.
Other tests that can be indicated for evaluations are excretory urography, urinary urethrography or renal scintigraphy, for example, which can evaluate more details of the anatomy and the flow of urine through the urinary tract. Understand how it is done and the indications for excretory urography.
How the treatment is done
Treatment for pyelocalytic dilation in a newborn depends on the size of the dilation. When the dilation is less than 10 mm, the baby only needs to do several ultrasounds for the pediatrician to control its evolution, as the dilation tends to disappear normally.
When the dilation is greater than 10 mm, treatment is done with antibiotics prescribed by the pediatrician. In the most severe cases, where the dilation is greater than 15 mm, surgery is recommended to correct the cause of the dilation.
In adults, the treatment of pyelocalyal dilation can be done with medications prescribed by the urologist or nephrologist, and surgery may be necessary, according to the kidney disease that caused the dilation.
