Dietl’s crisis

Dietl’s crisis is characterized by abdominal pain and vomiting most common in preschool age children and is characterized by an accessory renal artery or vein, which is asymptomatic at baseline but leads to acute obstruction of the ureteral pelvic junction during states of increased urine flow.

The incidence of Dietl’s crisis has been reported to be from 11% to 15% in children.

Fluid loading or feeding in young children causes Dietl’s crisis and children often become symptomatic during the forced diuresis phase of dynamic scintigraphy scan with a diuretic. 

Pyeloplasty results in the resolution of pain symptoms. 

Alternative procedures  include minimally invasive keyhole surgery, ureteric hitch, endoscopic balloon dilation or stenting. 

Surgical intervention relieves obstruction and results in good postoperative functional recovery.

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