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Clinical Study and Availability of Ultrasonography in Hemorrhagic Cystitis

Journal of the Korean Pediatric Society 1992;35(12):1722-1727.
Published online December 15, 1992.
Clinical Study and Availability of Ultrasonography in Hemorrhagic Cystitis
Jin Park1, Chi Hyung Park1, Chong Woo Bae1, Sung Ho Cha1, Byoung Soo Cho1, Chang Il Ahn1, Young Tae Ko2, Sun Wha Lee2
1Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
2Department of Diagnostic Radiology, College of Medicine, Kyung Hee University, Seoul, Korea
급성 출혈성 방광염에 대한 임상적 연구와 초음파 진단
박진1, 박치형1, 배종우1, 차성호1, 조병수1, 안창일1, 고영태2, 이선화2
1경희대학교 의과대학 소아과학교실
2경희대학교 의과대학 진단 방사선과학교실
Acute hemorrhagic cystitis characterized by gross hematuria and symptoms of bladder irritation occurs in children as a self-limited disease that must be differentiated from serious renal disease. We analyzed 22 cases of hemorrhagic cystitis which were managed in the Dept. of pediatrics, Kyung Hee university hospital and present the availability of bladder sonography for diagnosis of hemorrhagic cystitis and for follow-up. The results were as followings. 1) Among the 22 cases 15 were male, 7 were female and mean age of onset was 6 years. 2) On admission, the chief complaint was gross hematuria (19 cases) and the common symptoms during illness were gross hematuria, frequency, dysuria, fever, lower abdominal pain, nocturia in that order. 3) On urinalysis, all cases revealed hematuria, and associated with pyuria (WBC 5-40/HPF) in 11 cases. E. coli was cultured in 3 cases, A. calcoaceticus and M. morganii in 1 case. Antigen and antibody test for adenovirus 11 were studied with the blood from 4 patients who were diagnosed hemorrhagic cystitis, but all cases resulted negative. 4) IVP was done in 6 cases, only 2 cases revealed irregular bladder wall and decreased bladder capacity. On the other hand, bladder sonography was done in 10 cases, 9 cases of 10 cases showed irregular bladder wall or irregular thickening of bladder wall. Follow-up sonography revealed normalization of bladder wall average in 10 days. 6) Gross hematuria persisted for 6 days and abnormal urinalysis finding persisted for 10 days. Acute hemorrhagic cystitis is a benign self-limited disease of childhood which presents suddenly with gross hematuria, dysuria, frequency and urgency. As a work-up of hematuria, bladder sonography is mandatory for detection of hemorrhagic cystitis, so that we can avoid invasive methods such as IVP, cystoscopy or renal biopsy.
Key Words: Hemorrhagic cystitis, Gross hemturia, Bladder irritation sign, Bladder sonography

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