All issues > Volume 35(12); 1992

Original Article

J Korean Pediatr Soc. 1992;35(12):1722-1727. Published online December 15, 1992.

Clinical Study and Availability of Ultrasonography in Hemorrhagic Cystitis

Jin J Park¹, Chi Hyung CH Park¹, Chong Woo CW Bae¹, Sung Ho SH Cha¹, Byoung Soo BS Cho¹, Chang Il CI Ahn¹, Young Tae YT Ko², Sun Wha SW Lee²

¹Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
²Department of Diagnostic Radiology, College of Medicine, Kyung Hee University, Seoul, Korea

Abstract

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.

Keywords :Hemorrhagic cystitis, Gross hemturia, Bladder irritation sign, Bladder sonography